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在重症监护室患者中低血糖的发生率和预测因素:一项队列研究
Christian Lange Gantzel1, Mikkel Thor Olsen2, Ulrik Pedersen-Bjergaard3,4
1Department of Anesthesiology and Intensive Care, Copenhagen University Hospital-North Zealand, Hilleroed, Denmark.
Acta anaesthesiologica Scandinavica
|November 20, 2025
概括
低血糖症在重症监护室 (ICU) 患者中很常见,特别是在第一天. 早期识别低血糖和高血糖的危险因素对于更好地管理危急病患者的葡萄糖至关重要.
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.
- 临床研究 临床研究
背景情况:
- 重症监护室 (ICU) 患者经常出现失糖症 (高血糖症,低血糖症,血糖变异),影响治疗结果.
- 早期识别风险患者可以改善预防和管理策略.
研究的目的:
- 为了确定严重病情的成年人中失糖症的发生率.
- 在ICU中识别糖尿病早期预测因素.
主要方法:
- 一项前性队列研究,对577名入住混合医疗外科ICU的成年患者进行了研究.
- 在前5天,通过临床检测监测血糖.
- 血糖失调的预测因素在入院的第一天被评估.
主要成果:
- 低血糖 (≤3.9 mmol/L) 发生在8.2%的患者中,最常见的是第一天.
- 过高血糖的危险因素包括高摄入葡萄糖,葡萄糖皮质激素治疗和糖尿病.
- 低血糖的危险因素包括慢性病,急性损伤,糖尿病,败血症,较高的SOFA得分和手术入院.
结论:
- 低血糖在早期的ICU住院中很普遍,而高血糖则显示出较少的每日变化.
- 特定的患者因素预测高血糖和低血糖,有助于早期风险识别.
- 加强对早期失糖症风险评估的关注,可以优化重症患者的葡萄糖管理.
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