Haemodialysis, nutritional disorders and hypoglycaemia in critical care.
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.
Nursing Department, Instituto do Coração (Heart Institute), Hospital das Clínicas da Escola de Medicina da Universidade de São Paulo, Brazi.
Jeiel Carlos Lamonica
JC
Crespo
Nursing Department, Instituto do Coração (Heart Institute), Hospital das Clínicas da Escola de Medicina da Universidade de São Paulo, Brazil.
Vanessa Rossato
VR
Gomes
Geomatics, Instituto de Geografia, Universidade Federal de Uberlândia, Brazil.
Ricardo Luís
RL
Barbosa
Medical-Surgical Nursing Department, Escola de Enfermagem da Universidade de São Paulo, Brazil.
Katia Grillo
KG
Padilha
Medical-Surgical Nursing Department, Escola de Enfermagem da Universidade de São Paulo, Brazil.
Silvia Regina
SR
Secoli
D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002395:Catecholamines / Q000627:therapeutic use*; D015331:Cohort Studies; D015897:Comorbidity; D016638:Critical Illness / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000453:epidemiology; D004750:Enteral Nutrition; D005260:Female; D005947:Glucose / Q000627:therapeutic use; D017052:Hospital Mortality; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000453:epidemiology*; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D015994:Incidence; D007328:Insulin / Q000009:adverse effects*; D007362:Intensive Care Units; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009726:Nurses; D010288:Parenteral Nutrition; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D014839:Vomiting; D016526:Workload / Q000706:statistics & numerical data; D055815:Young Adult
D002395:Catecholamines; D007004:Hypoglycemic Agents; D007328:Insulin; D005947:Glucose
Critical care; Glucose; Hypoglycaemia; Simplified Acute Physiology Score