title: [Management of glycemia: an audit in 66 ICUs].
abstract: BACKGROUND
  The interest of tight glucose control in ICU is still debated. In France, no data are available regarding this therapy and the implementation of its guidelines.
  
  
  METHODS
  Sub-study of a one-day audit performed between January and May 2009.
  
  
  METHODS
  During a one-day audit performed in 66 ICUs, trained residents collected data regarding the presence of a formal glucose control protocol and its practical application.
  
  
  RESULTS
  A formalized glucose control protocol was found in 88% of patients. During the day before the audit, 3645 glycemia measurements were performed accounting for six measurements [4-9] per patient with a median higher value of 1.6 [1.4-2.1]. Hypoglycemia (<0.8 g/L) and hyperglycemia (>1.4 g/L in non-diabetic and >1.8 g/L in diabetic patients) were found in 81 (15%) and 326 (58%) patients respectively. Two episodes (0.36%) of severe hypoglycemia (<0.4 g/L) were reported. Factors associated with glucose control protocol application were: a high SOFA score, cardioversion, mechanical ventilation, intracranial pressure monitoring, steroid use and nurse to patient ratio less than 1/2.5. Hepatic failure was the only factor associated with hypoglycemia.
  
  
  CONCLUSIONS
  Glucose control protocols are available in more than 80% ICUs but their implementation is still imperfect. However, the median glycemia meets international current recommendations. Severe hypoglycemia is a very rare event in ICU.
authors: Réanimation médicochirurgicale, hôpital Saint-Roch, CHU de Nice, rue Pierre-Dévoluy, 06006 Nice cedex, France. orban.jc@chu-nice.fr
authors: J-C
authors: JC
authors: Orban
authors: A
authors: A
authors: Scarlatti
authors: J-Y
authors: JY
authors: Lefrant
authors: N
authors: N
authors: Molinari
authors: M
authors: M
authors: Leone
authors: S
authors: S
authors: Jaber
authors: J-M
authors: JM
authors: Constantin
authors: B
authors: B
authors: Allaouchiche
authors: C
authors: C
authors: Ichai
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000187:drug effects*; D002985:Clinical Protocols; D003422:Critical Care; D048909:Diabetes Complications / Q000628:therapy; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy; D004554:Electric Countershock; D005260:Female; D005602:France; D017408:Guidelines as Topic; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D007003:Hypoglycemia / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D007362:Intensive Care Units / Q000458:organization & administration*; D007427:Intracranial Pressure / Q000502:physiology; D017093:Liver Failure / Q000150:complications / Q000628:therapy; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009726:Nurses; D012121:Respiration, Artificial; D012307:Risk Factors; D013256:Steroids / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D001786:Blood Glucose; D013256:Steroids