Clinical effects of intensive insulin therapy treating traumatic shock combined with multiple organ dysfunction syndrome

Du, Jundong; Liu, Hongming; Liu, Rong; Yao, Yong‐Ming; Jiao, Huabo; Zhao, Xiaodong; Yin, Hui; Li, Zhanliang

doi:10.1007/s11596-011-0251-4

Cited by 3 publications

(2 citation statements)

References 21 publications

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“…A previous study, conducted by the authors of the present study, has demonstrated that IIT improves the prognosis of patients with injury and with pyemia and decreases their fatality rates (26). Another study has reported that LMWH noticeably improves the prognosis of hyperlipidemic pancreatitis and that the underlying mechanisms may be correlated with the improvement of microcirculation, catabolism and anabolism, and the promotion of anti-inflammatory reactions (27).…”

Section: Discussionsupporting

confidence: 49%

Effects of intensive insulin therapy combined with low molecular weight heparin anticoagulant therapy on severe pancreatitis

Zheng

Huang³

et al. 2014

Experimental and Therapeutic Medicine

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The current study explored the effects of intensive insulin therapy (IIT) combined with low molecular weight heparin (LMWH) anticoagulant therapy on severe acute pancreatitis (SAP). A total of 134 patients with SAP that received treatment between June 2008 and June 2012 were divided randomly into groups A (control; n=33), B (IIT; n=33), C (LMWH; n=34) and D (IIT + LMWH; n=34). Group A were treated routinely. Group B received continuous pumped insulin, as well as the routine treatment, to maintain the blood sugar level between 4.4 and 6.1 mmol/l. Group C received a subcutaneous injection of LMWH every 12 h in addition to the routine treatment. Group D received IIT + LMWH and the routine treatment. The white blood cell count, hemodiastase, serum albumin, arterial partial pressure of oxygen and prothrombin time were recorded prior to treatment and 1, 3, 5, 7 and 14 days after the initiation of treatment. The intestinal function recovery time, incidence rate of multiple organ failure (MOF), length of hospitalization and fatality rates were observed. IIT + LMWH noticeably increased the white blood cell count, hemodiastase level, serum albumin level and the arterial partial pressure of oxygen in the patients with SAP (P<0.05). It markedly shortened the intestinal recovery time and the length of stay and reduced the incidence rate of MOF, the surgery rate and the fatality rate (P<0.05). It did not aggravate the hemorrhagic tendency of SAP (P>0.05). IIT + LMWH had a noticeably improved clinical curative effect on SAP compared with that of the other treatments.

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Section: Discussionsupporting

confidence: 49%

Effects of intensive insulin therapy combined with low molecular weight heparin anticoagulant therapy on severe pancreatitis

Zheng

Huang³

et al. 2014

Experimental and Therapeutic Medicine

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“…Clinicians in the People’s Republic of China have attributed gastrointestinal dysfunction to MODS since 1995. 12 In their scoring system, abdominal bloating or decreased bowel sound is counted as 1 point, a high amount of abdominal bloating or almost disappearing bowel sound is counted as 2 points, and paralytic ileus or stress ulcer bleeding is counted as 3 points. As this scores system can quantify the intestinal dysfunction, it is usually applied to evaluate gastrointestinal function of critical patients in clinical practice and trials by Chinese clinicians.…”

Section: Discussionmentioning

confidence: 99%

Acute gastrointestinal injury in the intensive care unit: a retrospective study

Chen¹,

Zhang²,

Li³

et al. 2015

TCRM

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BackgroundAcute gastrointestinal injury (AGI) is a common problem in the intensive care unit (ICU). This study is a review of the gastrointestinal function of patients in critical care, with the aim to assess the feasibility and effectiveness of grading criteria developed by the European Society of Intensive Care Medicine (ESICM) Working Group on Abdominal Problems (WGAP).MethodsData of patients who were admitted to the ICU of Shenzhen People’s Hospital, Shenzhen, People’s Republic of China, from January 2010 to December 2011 were reviewed. A total of 874 patients were included into the current study. Their sex, age, ICU admissive causes, complication of diabetes, AGI grade, primary or secondary AGI, mechanical ventilation (MV), and length of ICU stay (days) were recorded as risk factors of death. These risk factors were studied by unconditioned logistic regression analysis.ResultsAll the risk factors affected mortality rate. Unconditional logistic regression analysis revealed that the mortality rate of secondary AGI was 71 times higher than primary AGI (odds ratio [OR] 4.335, 95% CI [1.652, 11.375]). When the age increased by one year, the mortality probability would increase fourfold. Mortality in patients with MV was 63-fold higher than for patients with non-MV. Mortality rate increased 0.978 times with each additional day of ICU stay.ConclusionSecondary AGI caused by severe systemic conditions can result in worsened clinical outcomes. The 2012 ESICM WGAP AGI recommendations were to some extent feasible and effective in guiding clinical practices, but the grading system lacked the support of objective laboratory outcomes.

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Analysis of Bowel Sounds Application Status for Gastrointestinal Function Monitoring in the Intensive Care Unit

Tang

et al. 2014

Critical Care Nursing Quarterly

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The auscultation of bowel sounds (BS) has been neglected as a reliable tool for determining gastrointestinal (GI) functioning in the critically ill patient. This article considers the validity of BS auscultation in the assessment and management of critically ill patients and outlines how the information may be utilized for monitoring GI function. A descriptive, cross-sectional design with self-administered questionnaires was used to survey 132 nurses and 38 doctors in the 6 general intensive care units in Beijing hospitals. Descriptive statistics and chi-square test analyses were used to assess the level of knowledge about BS among Chinese doctors and nurses and to determine how they applied their BS auscultation findings in the care of critically ill patients. Bowel sounds were found to be the primary indicator for determining GI functioning in the unconscious, critically ill patient. However, only 11.4% of nurses and 47.6% of doctors could make correct clinical judgments on the basis of their auscultatory findings. The attitudes of nurses and doctors differed significantly on whether BS auscultation was needed to monitor GI function for unconscious patients. Bowel sounds auscultation remains an important indicator of GI function. Distinct and feasible standards regarding BS auscultation and results interpretation need to be established.

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Clinical effects of intensive insulin therapy treating traumatic shock combined with multiple organ dysfunction syndrome

Cited by 3 publications

References 21 publications

Effects of intensive insulin therapy combined with low molecular weight heparin anticoagulant therapy on severe pancreatitis

Effects of intensive insulin therapy combined with low molecular weight heparin anticoagulant therapy on severe pancreatitis

Acute gastrointestinal injury in the intensive care unit: a retrospective study

Analysis of Bowel Sounds Application Status for Gastrointestinal Function Monitoring in the Intensive Care Unit

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