ArticleIntensive care medicine2012
Risk factors for hypoglycaemia in neurocritical care patients.
Article in Intensive care medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 12 citations in OpenAlex.
- Effects of glucose-dependent insulinotropic polypeptide on gastric emptying, glycaemia and insulinaemia during critical illness: a prospective, double blind, randomised, crossover study.Critical care (London, England) · 2015Trial
- Association between Blood Glucose and cardiac Rhythms during pre-hospital care of Trauma Patients - a retrospective Analysis.Scandinavian journal of trauma, resuscitation and emergency medicine · 2018Article
- Year in review in Intensive Care Medicine 2012: I. Neurology and neurointensive care, epidemiology and nephrology, biomarkers and inflammation, nutrition, experimentals.Intensive care medicine · 2013Article
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Authors and funding
9 authors at 3 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
purposeTo identify risk factors for hypoglycaemia in neurocritical care patients receiving intensive insulin therapy (IIT).
methodsWe performed a nested case-control study. All first episodes of hypoglycaemia (glucose <80 mg/dL, <4.4 mmol/L) in neurocritical care patients between 1 March 2006 and 31 December 2007 were identified. Patients were treated according to the local IIT protocol, with target blood glucose levels between 4.5 and 6.0 mmol/L (81.0-108.0 mg/dL). The first hypoglycaemic event of every patient (index moment) was used to match to a control patient. Possible risk factors preceding the index moment were scored using hospital records and analysed with conditional logistic regression.
resultsOf 786 neurocritical care patients, 449 developed hypoglycaemia (57.1 %). Independent risk factors for hypoglycaemia were lowering nutrition 6 h before the index moment without insulin dose reduction (odds ratio (OR) 5.25, 95 % confidence interval (95 % CI) 1.32-20.88), mechanical ventilation (OR 2.59, 95 % CI 1.56-4.29), lowering the dosage of norepinephrine 3 h before the index moment (OR 2.44, 95 % CI 1.07-5.55), a hyperglycaemic event (>10 mmol/L, >180.0 mg/dL) in the 24 h preceding the index moment (OR 2.40, 95 % CI 1.26-4.58), gastric residual in the 6 h preceding the index moment without insulin dose reduction (OR 1.76, 95 % CI 1.05-2.96) and dosage of insulin at the index moment (OR 0.83, 95 % CI 0.76-0.90).
conclusionHypoglycaemia occurs in a considerable proportion of neurocritical care patients. We recommend the identification of these risk factors in these patients to avoid the occurrence of hypoglycaemia.
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