相关实验视频
Updated: Jul 15, 2025

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
在ICU中严格控制血糖,没有早期的肠胃营养
Jan Gunst1, Yves Debaveye1, Fabian Güiza1
1From the Clinical Department of Intensive Care Medicine (J.G., Y.D., F.G., A.D.B., D.D., E.D.T., M.P.C., G.D.V., R.H., B.J., G.M., C.I., J.M., D.V., L.D., L.M., P.J.W., G.V.B.) and the Medical Intensive Care Unit (A.W., G.H.), University Hospitals of KU Leuven, Leuven, the Department of Anesthesiology and Intensive Care Medicine, Jessa Hospital, Hasselt (J.D., B.S., L.G., J. Vandenbrande, M.B., I.G., E.G., I.D.P.), and the Department of Intensive Care Medicine, Ghent University Hospital, Ghent (J. Vermassen, H.P., E.H., J.J.D.W., I.H., P.D., D.D.B.) - all in Belgium.
在重症监护病房 (ICU) 严格控制血糖,在不提供早期亲肠道营养时,并没有改变ICU护理时间或死亡率. 这项研究强调了在重症患者中考虑与血糖管理一起考虑营养支持的重要性.
科学领域:
- 关键护理医学 关键护理医学
- 内分泌学 在内分泌学.
- 临床试验 临床试验
背景情况:
- 在重症监护室 (ICU) 严格控制葡萄糖的先前研究产生了不一致的结果,有证据表明有益和有害.
- 早期亲肠道营养使用的变化和严重低血糖的发生率可能会解释这些差异.
研究的目的:
- 研究严格与自由血糖控制对重症病患的ICU治疗结果的影响.
- 评估一周暂停肠外营养对血糖控制策略的影响.
主要方法:
- 一项随机对照试验,涉及9230名入院于ICU的患者.
- 用LOGIC-胰岛素算法将患者分配到自由血糖控制 (胰岛素开始>215 mg/dL) 或严格的血糖控制 (目标80-110 mg/dL) 中.
- 在这两组中,第一个星期都不提供肠外营养.
主要成果:
- 紧张 (1.00;95% CI,0.96-1.04) 和自由的葡萄糖控制组之间活着离开ICU的中位时间没有显著差异.
- 类似的90天死亡率:自由主义组为10.1%,严格控制组为10.5% (P=0.51).
- 严格的血糖控制与严重急性损伤和胆固醇性肝功能障碍的发病率较低有关.
结论:
- 在不接受早期亲肠道营养的重症患者中,严格的血糖控制没有改变ICU护理的持续时间或整体死亡率.
- 这些发现表明,拒绝早期的肠外营养可能会减轻与ICU中严格的血糖控制相关的潜在危害.
相关概念视频
Hypoglycemia and Glucagon
Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
Diabetes: Management and Pharmacotherapy
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Insulin: Dosing Regimen and Adverse Effects
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
SBAR II: Application of SBAR
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
Glucose Homeostasis: Regulation of Blood Glucose
During fasting, when blood glucose levels are low, the pancreas secretes glucagon. it...

