Monitoring and management of blood glucose of patients with critical illness

doi:10.3969/j.issn.1002-7386.2018.12.015

Abstract：Objective To investigate the monitoring and management circumstance of blood glucose of patients with critical illness in Hebei province in order to better guide blood sugar management in patients with critical illness and improve the prognosis of patients by looking for the gap between practice and evidence-based medicine to set up effective scheme and improvement measures. Methods The patients with critical illness in ICU of 25 tertiary hospital in Hebei province from May 15, 2015 to July 15, 2015 were enrolled in the investigation. A database of information was built by the Epidata, which were collected from questionnaires named " The survey of acute gastrointestinal injury assessment and nutritional support current situation to critically ill patients in Hebei province-case report". The patients were divided into survival group and death group. T test,COX survival analysis and ROC curve analysis were used to analyze the data statistically by means of software SPSS 24. 0. Results Among the patients,11 patients (3. 4%)did not receive blood glucose monitoring. The average levels of blood glucose were (6. 6 ± 1. 1)mmol/L. During the investigation, the blood glucose levels of 3500 patients (27%) were more than 10mmol/L,which in 152 patients (1. 2%) were below 3. 5mmol/L,with the average fluctuation range of blood glucose being (9.2±3.2)mmol/L.Except for patient's age,there were significant differences in APACHEⅡscore,SOFA score,maximum value of blood glucose,minimum value of blood glucose and fluctuating value of blood glucose between 28-day death group and survival group. The fluctuation range of blood glucose could better predict 28-day mortality (AUC=0. 874). Moreover there was a close correlation between higher APACHEⅡscores and 28-day mortality in patients with critical illness (RR 1. 222). Conclusion Clinicians should pay much attention to blood glucose monitoring in patients with critical illness, use insulin to control blood sugar, keep blood glucose stable and avoid sharp fluctuation of blood glucose levels, moreover, blood glucose fluctuation can predict 28-day mortality better.