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Glucometrics and Measuring Blood Glucose in Critically Ill Patients

  • Gregory E. Evans
  • Donald Crabtree
  • Liza M. Weavind
Chapter

Abstract

Glucose homeostasis is dysregulated in critical illness, and “stress hyperglycemia” carries significant morbidity and is an independent risk factor for poor outcome after ICU admission. Clinicians, various regulatory organizations, and clinical societies have therefore drafted guidelines for the management of hyperglycemia in the critically ill. The institution of “tight glycemic control” utilizing insulin infusions to achieve blood glucose levels of 80–110 mg/dl was widely accepted following the publication of improved outcomes in critically ill patients in the initial Van den Berghe study in 2001. Many studies following, however, were unable to reproduce the outcomes realized in the first study and raised concern regarding increased frequency of hypoglycemia on intensive insulin therapy regimens. The purpose of this chapter is to evaluate the various methodologies utilized in ICUs to measure glucose levels that are then used to make treatment decisions regarding management of the hyperglycemia of critical illness. A comparison of point-of-care (POC) testing with glucose meters, arterial blood gas (ABG) measurements, and central laboratory (CLM) testing is explored with a focus on how measurements are made, accuracy, cost, and convenience.

Keywords

Glucose Oxidase Central Laboratory Glucose Measurement Glucose Dehydrogenase Tight Glycemic Control 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Gregory E. Evans
    • 1
  • Donald Crabtree
    • 2
  • Liza M. Weavind
    • 3
  1. 1.Division of Anesthesiology-Critical Care Medicine, Department of AnesthesiologyVanderbilt University Medical CenterNashvilleUSA
  2. 2.Division of Anesthesiology-Critical Care Medicine, Department of AnesthesiologyVanderbilt University Medical CenterNashvilleUSA
  3. 3.Division of Anesthesiology-Critical Care Medicine, Department of AnesthesiologyVanderbilt University Medical CenterNashvilleUSA

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