Accuracy of Bedside Capillary Blood Glucose Measurements in Critically Ill Patients.

Critchell, C. Dana; Callahan, Amy; Aboud, Christine; Jabbour, Serge; Marik, Paul E.

doi:10.1097/00003246-200612002-00240

Cited by 10 publications

(1 citation statement)

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“…This tendency for systematic overestimation has been noted in other studies as well (although some unpredictable underestimates has been shown to occur simultaneously). [91][92][93] For the practicing physician, it is important to be aware of these potential shortcomings of various measurement devices and be particularly cognizant of at-risk patients (those with 94 This threshold approximated that advocated by Finney and colleagues in their exploratory observational study where an upper limit target of 145 mg/dL was proposed. 95 In contrast, analysis of the pooled data set from the Leuven surgical ICU and medical ICU cohorts suggested that compared to a BG range of 110 to 150 mg/dL, mortality was higher in the subset of patients with BG >150 (OR 1.38, CI 1.10-1.75) and lower with BG <110 (OR 0.77, CI 0.61-0.96).…”

Section: The Nuances Of Glycemic Management In the Icu Measuring Glucose During Critical Illnessmentioning

confidence: 99%

Analytic Review: Glucose Controversies in the ICU

Honiden

Inzucchi

2010

J Intensive Care Med

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Hyperglycemia is common in critical illness and has been associated with increased morbidity and mortality. An era of tight glucose control began when intensive insulin therapy was shown to improve outcomes in a single-center randomized trial. More recently, with the publication of additional studies, questions have been raised regarding the efficacy and safety of intensive glycemic management. This article will review the biologic mechanisms that may help us understand why and how hyperglycemia and insulin are relevant in critical illness. We will then explore insights gleaned from available clinical trials. Finally, we will discuss specific areas of controversy that relate to the implementation of glycemic control in the intensive care unit, such as the ideal glucose target and the importance of hypoglycemia.

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