Tight Blood-Glucose Control without Early Parenteral Nutrition in the ICU

Tight Blood-Glucose Control without Early Parenteral Nutrition in the ICU

In critically ill patients who were not receiving early parenteral nutrition, tight glucose control did not affect the length of time that ICU care was needed or mortality. Of 9,230 patients who underwent randomization,... read more

High Dose Insulin and Euglycemia Therapy for Beta-adrenergic Receptor Treatment and Calcium Channel Antagonists Overdose

High Dose Insulin and Euglycemia Therapy for Beta-adrenergic Receptor Treatment and Calcium Channel Antagonists Overdose

High dose insulin with dextrose supplementation is indicated for patients with calcium channel blocker and beta blocker overdose and signs of cardiac toxicity. Mechanisms are not completely elucidated, but mostly related... read more

The Truth About High-Dose Insulin

The Truth About High-Dose Insulin

The agent involved when our poison center is consulted about cases of calcium channel blocker (CCB) poisoning these days is almost invariably amlodipine. Quite often, the clinical team will be reaching for high-dose insulin... read more

Higher CRP Rise Not Related To Cytokine Response

Higher CRP Rise Not Related To Cytokine Response

The higher C-reactive protein (CRP) rise with late parenteral nutrition (PN), explained by the early macronutrient deficits, did not relate to cytokine responses and thus did not reflect more systemic inflammation. Instead... read more

Addressing Hospital-Acquired Hypoglycemia

Addressing Hospital-Acquired Hypoglycemia

Findings suggest that ensuring a consistent 30-minute window between POC BG measurement and meal delivery enabled nursing staff to perform timely POC BG measurements and administer a more optimal mealtime insulin dose. Increasing... read more

Stress Hyperglycemia and Mortality in Subjects With Diabetes and Sepsis

Stress Hyperglycemia and Mortality in Subjects With Diabetes and Sepsis

Stress-induced hyperglycemia is a relevant prognostic factor also in the presence of diabetes. Mild-to-moderate stress hyperglycemia is considered a protective reaction to providing fuel for the immune system and brain at... read more

Pragmatic Approach to Inpatient Diabetes Management During COVID-19

Pragmatic Approach to Inpatient Diabetes Management During COVID-19

The pandemic of COVID-19 has presented new challenges to hospital personnel providing care for infected patients with diabetes who represent more than 20% of critically ill patients in ICUs. Appropriate glycemic management... read more

Rapid Advancement in Enteral Nutrition Does Not Affect Systemic Inflammation and Insulin Homeostasis Following Pediatric Cardiopulmonary Bypass Surgery

Rapid Advancement in Enteral Nutrition Does Not Affect Systemic Inflammation and Insulin Homeostasis Following Pediatric Cardiopulmonary Bypass Surgery

A FF strategy was not associated with changes to early enteral nutrition delivery. Inflammation, insulin resistance, and morbidity were similar, but FF may modify the relationship between inflammation and adverse event. Multicenter... read more

Lower Glucose Targets Show Improved Mortality in Cardiac Patients

Lower Glucose Targets Show Improved Mortality in Cardiac Patients

Tighter glucose control while minimizing the risk of severe hypoglycemia is associated with lower mortality among critically ill cardiac patents, new research suggests. Researchers reported in CHEST on the outcomes of... read more

Incidence of Hypoglycemia in Following Insulin‐based Acute Treatment of Hyperkalemia

Incidence of Hypoglycemia in Following Insulin‐based Acute Treatment of Hyperkalemia

Iatrogenic hypoglycemia, as a result of treatment for hyperkalemia, is a common occurrence. Hyperkalemia occurs disproportionately in patients with acute kidney injury or end‐stage renal disease, and these patients are... read more

Acute Hyperglycemic Emergencies

Acute Hyperglycemic Emergencies

As diabetes prevalence increases in the US, critical care nurses need to be familiar with the acute hyperglycemic emergencies they may encounter in the ED or ICU. This article focuses on the diagnosis of, various treatments... read more

Hypertriglyceridemic pancreatitis: Can we defuse the bomb?

Hypertriglyceridemic pancreatitis: Can we defuse the bomb?

Hypertriglyceridemia causes ~9% of pancreatitis, the third most common cause after alcohol and gallstones. It is a risk factor for severe pancreatitis, making it more frequent among ICU patients with pancreatitis. I see... read more

Electrophysiological Investigations of Peripheral Nerves and Muscles

Electrophysiological Investigations of Peripheral Nerves and Muscles

Resting trans-membrane potential difference (Em) of skeletal muscle is correlated to the energy status of the organism: the more severe the illness, the lower the Em. In 1971, Cunningham demonstrated this association with... read more

What constitutes optimal glucose management in Critical Care?

Glycaemic Control in the EU. Following on from the poster we presented at the Intensive Care Society. We asked Sphere Medical's own Dr Gavin Troughton to present at our launch event. In the below video he goes into more... read more