British journal of nursing (Mark Allen Publishing) · 2017
Haemodialysis, nutritional disorders and hypoglycaemia in critical care.
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Crespo Jeiel Carlos Lamonica, Gomes Vanessa Rossato, Barbosa Ricardo Luís, Padilha Katia Grillo, Secoli Silvia Regina
Аннотация
This study aimed to determine hypoglycemia incidence and associated factors in critically ill patients. It looked at a retrospective cohort with 106 critically ill adult patients with 48 hours of glycaemic control and 72 hours of follow up. The dependent variable, hypoglycaemia (≤70 mg/dl), was assessed with respect to independent variables: age, diet, insulin, catecholamines, haemodialysis, nursing workload and the Simplified Acute Physiology Score. Statistical analysis was performed using Student's t-test, Fisher's exact test and logistic regression at 5% significance level. Incidence of hypoglycaemia was 14.2%. Hypoglycaemia was higher in the group of patients on catecholamines (p=0.040), with higher glycaemic variability (p<0.001) and death in the intensive care unit (p=0.008). Risk factors were identified as absence of oral diet (OR 5.11; 95% CI 1.04-25.10) and haemodialysis (OR 4.28; 95% CI 1.16-15.76). Patients on haemodialysis and with no oral diet should have their glycaemic control intensified in order to prevent and/or manage hypoglycaemic episodes.
Предметные рубрики MeSH
APACHEAdolescentAdultAgedAged, 80 and overCatecholaminesCohort StudiesComorbidityCritical IllnessDiabetes MellitusEnteral NutritionFemaleGlucoseHospital MortalityHumansHypoglycemiaHypoglycemic AgentsIncidenceInsulinIntensive Care UnitsKidney Failure, ChronicMaleMiddle AgedNursesParenteral NutritionRenal DialysisRetrospective StudiesRisk FactorsVomitingWorkloadYoung Adult