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Critical Region, Critical Values and Significance Level01:16

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The critical region, critical value, and significance level are interdependent concepts crucial in hypothesis testing.
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Critical thinking helps decision-making and allows nurses to recognize barriers to success and find solutions to possible issues. It helps to brainstorm and implement ideas to achieve goals. Critical thinking helps acknowledge and state workflow inefficiencies while improving management techniques. Nurses understand the value of critical thinking and look for fellow nurses with critical thinking skills to upgrade their professional standards. Critical thinking can advance a nurse's career...
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Glucose Management Technologies for the Critically Ill.

Pedro D Salinas1, Carlos E Mendez2

  • 11 Aurora Critical Care Services, University of Wisconsin School of Medicine and Public Health, Milwaukee, WI, USA.

Journal of Diabetes Science and Technology
|January 15, 2019
PubMed
Summary
This summary is machine-generated.

Managing blood sugar in the intensive care unit (ICU) is complex. Current guidelines suggest targeting 140-180 mg/dL for hyperglycemia, balancing risks of intensive insulin therapy and hypoglycemia.

Keywords:
continuous glucose monitoringelectronic glucose management systemsglucose management technologiesintensive care unit

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Area of Science:

  • Critical Care Medicine
  • Endocrinology
  • Clinical Chemistry

Background:

  • Hyperglycemia is prevalent in intensive care unit (ICU) patients, irrespective of prior diabetes status.
  • The ideal glycemic target in critically ill patients remains under investigation.
  • Current recommendations advocate for treating hyperglycemia when glucose levels exceed 180 mg/dL, aiming for 140-180 mg/dL to mitigate hypoglycemia risks.

Purpose of the Study:

  • To review the current understanding and challenges in glycemic control for ICU patients.
  • To discuss the limitations of current glucose monitoring methods and insulin delivery strategies.
  • To explore the potential of emerging technologies in improving inpatient glycemic management.

Main Methods:

  • Literature review of studies on hyperglycemia management in ICU settings.
  • Analysis of current guidelines and recommendations for glycemic control.
  • Evaluation of point-of-care glucose meters and continuous glucose monitoring (CGM) accuracy.
  • Discussion of intravenous insulin protocols and emerging technologies.

Main Results:

  • Point-of-care glucose monitoring devices show variable accuracy and require cautious use.
  • Continuous glucose monitoring (CGM) is not yet standard for inpatient use.
  • Intravenous insulin therapy, guided by protocols, is the predominant method for critically ill patients.
  • New technologies like electronic glucose management and closed-loop systems show promise for better glycemic control.

Conclusions:

  • Optimal glucose control in the ICU is debated, with current targets balancing hyperglycemia and hypoglycemia.
  • Limitations in glucose monitoring accuracy and delivery methods persist.
  • Technological advancements offer potential for improved glycemic management and reduced hypoglycemia in critically ill patients.