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The optimal blood glucose level for critically ill adult patients

Citation

Shaoning, L and Ross, P and Tori, K, The optimal blood glucose level for critically ill adult patients, Nursing in Critical Care, 22, (5) pp. 312-319. ISSN 1362-1017 (2017) [Refereed Article]

Copyright Statement

Copyright 2017 British Association of Critical Care Nurses

DOI: doi:10.1111/nicc.12285

Abstract

Background: Glycaemic control is recognized as one of the important aspects in managing critically ill patients. Both hyperglycaemia and hypoglycaemia independently increase the risk of patient mortality. Hence, the identification of optimal glycaemic control is of paramount importance in the management of critically ill patients.

Aims and objectives: The aim of this literature review is to examine the current status of glycaemic control in critically ill adult patients. This literature review will focus on randomized controlled trials comparing intensive insulin therapy to conventional insulin therapy, with an objective to identify optimal blood glucose level targets for critically ill adult patients.

Design and methods: A literature review was conducted to identify large randomized controlled trials for the optimal targeted blood glucose level for critically ill adult patients published since 2000. A total of eight studies fulfilled the selection criteria of this review.

Results: With current human and technology resources, the results of the studies support commencing glycaemic control once the blood glucose level of critically ill patients reaches 10 mmol/L and maintaining this level between 8 mmol/L and 10 mmol/L.

Conclusion: This literature review provides a recommendation for targeting the optimal blood glucose level for critically ill patients within moderate blood glucose level target range (810 mmol/L). The need for uniformed glucometrics for unbiased reporting and further research for optimal blood glucose target is required, especially in light of new technological advancements in closed‐loop insulin delivery and monitoring devices.

Relevance to clinical practice: This literature review has revealed a need to call for consensus in the measurement and reporting of glycaemic control using standardized glucometrics.

Item Details

Item Type:Refereed Article
Keywords:critical care nursing, adult intensive care, critical pathways
Research Division:Medical and Health Sciences
Research Group:Nursing
Research Field:Nursing not elsewhere classified
Objective Division:Health
Objective Group:Health and Support Services
Objective Field:Nursing
UTAS Author:Tori, K (Associate Professor Kathleen Tori)
ID Code:133920
Year Published:2017
Web of Science® Times Cited:1
Deposited By:Nursing
Deposited On:2019-07-16
Last Modified:2019-08-13
Downloads:0

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