[Association between glucose variability and poor prognosis in critically ill patients].

OBJECTIVE

To explore the association between glucose variability and poor prognosis in critically ill patients.

METHODS

This prospective study was undertaken in a 24-bed intensive care unit (ICU). A total of 145 patients staying for over 24 hours in ICU were enrolled. Their arterial levels of blood glucose were measured four times daily routinely. And the mean glucose level (MGL), standard deviation (SD) and coefficient of variation (CV) were calculated. The incidence of moderate hypoglycemia (MH), severe hypoglycemia (SH), total dosage of hormone, average daily dosage of insulin, duration of renal replacement- therapy (RRT), mechanical ventilation and ICU free days were also recorded. They were divided into survival (n = 85) and nonsurvival (n = 60) groups according to survival or not at 28 days. And CV was compared between two groups and the relationship of CV and mortality examined.

RESULTS

The nonsurvival group had higher CV value accompanied by higher RRT proportion, higher incidences of MH and SH, shorter free mechanical ventilation time and free ICU stay. The higher CV value was found in surviving nondiabetics. However, no significant difference existed in diabetes group.

CONCLUSION

Critically ill patients have higher CV of glucose variability especially in non-diabetic patients. Blood glucose fluctuations denote a worse prognosis. And hypoglycemia should raise a high alert. Frequent blood glucose monitoring is beneficial to detecting the changes of condition and adjusting treatment regimens accordingly.