title: Glucose Levels in Patients With Acute Respiratory Failure Requiring Mechanical Ventilation.
abstract: BACKGROUND
  Recent studies suggest that patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) frequently develop hyperglycemia, which has been linked to adverse outcomes.
  
  
  METHODS
  We retrospectively collected information about patient demographics, admission diagnosis, comorbidities, use of insulin, and glucose levels and related tests in 174 patients who required mechanical ventilation for acute respiratory failure.
  
  
  RESULTS
  These patients had a mean age of 57.8 ± 16.8 years, a mean Acute Physiology and Chronic Health Evaluation (APACHE II) score of 13.8 ± 6.1, and an overall mortality of 32.2%. The mean number of ventilator days was 7.5 ± 7.1. The mean highest glucose level was 239.3 ± 88.9 mg/dL in patients with COPD (n = 41) and 259.1 ± 131.7 mg/dL in patients without COPD (n =133). Patients with diabetes had higher glucose levels than patients without this diagnosis ( P < .05). Patients receiving corticosteroids did not have increased glucose levels ( P > .05). The mortality rate was higher in patients with glucose levels >140 mg/dL than in patients below 140 mg/dL (35.1% vs 10.5%, P < .05 unadjusted analysis).
  
  
  CONCLUSIONS
  In this study, hyperglycemia occurred in 89% of the patients with acute respiratory failure requiring mechanical ventilation. The most important risk factor for this was a premorbid diagnosis of diabetes.
authors.affiliation: 1 Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
authors.forename: Hawa
authors.initials: H
authors.lastname: Edriss
authors.affiliation: 1 Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
authors.forename: Kavitha
authors.initials: K
authors.lastname: Selvan
authors.affiliation: 1 Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Sigler
authors.affiliation: 1 Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Nugent
mesh_terms: D018806:APACHE; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood* / Q000150:complications / Q000628:therapy; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D012128:Respiratory Distress Syndrome / Q000097:blood* / Q000150:complications / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D001786:Blood Glucose
keywords: COPD; acute respiratory failure; hyperglycemia; mechanical ventilation; mortality