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New cause of critical illness hypeglycemia identified
February 26, 2009The endocrinologic basis of pediatric critical illness hypergylcemia (CIH) differs depending on the disease processes. Researchers writing in BioMed Central's open access journal Critical Care describe how both peripheral insulin resistance and primary beta-cell dysfunction can cause CIH in children.
Catherine Preissig and Mark Rigby from the Emory University School of Medicine, Atlanta, USA, studied 41 children receiving intensive care treatment. They found that those with respiratory failure only had CIH caused by elevated insulin resistance, while those with both respiratory and cardiovascular failure had CIH caused by primary beta-cell dysfunction. Preissig said, "Understanding the etiology of CIH may significantly impact disease course and therapeutic approach. Further studies must confirm whether insulin treatment is effective in both subgroups of patients".
CIH is highly prevalent in pediatric critical illness; the authors estimate that approximately 20% of admissions to their ICU develop the condition. They found that as well as the etiological differences described above, patients with respiratory failure and cardiovascular failure also had more severe CIH than those with respiratory failure alone. Preissig concludes, "Understanding these differences and elucidating the pathogenesis of CIH may assist in developing individualized glycemic goals and treatment strategies in children with life-threatening illness or injury".
BioMed Central
BioMed Central
Critical Illness Current Events and Critical Illness News RSSMuscle weakness a common side effect of long stays in intensive care units
After decades of focusing on the management of respiratory failure, circulatory shock and severe infections that lead to extended stays in hospital intensive care units, critical care researchers are increasingly turning attention to what they believe is a treatable complication developed by many who spend days or weeks confined to an ICU bed: debilitating muscle weakness that can linger long after hospital discharge.
H1N1 critical illness can occur rapidly; predominantly affects young patients
Critical illness among Canadian patients with 2009 influenza A(H1N1) occurred rapidly after hospital admission, often in young adults, and was associated with severely low levels of oxygen in the blood, multi-system organ failure, a need for prolonged mechanical ventilation, and frequent use of rescue therapies.
Critical illness from 2009 H1N1 in Mexico associated with high fatality rate
Critical illness from 2009 influenza A(H1N1) in Mexico occurred among young patients, was associated with severe acute respiratory distress syndrome and shock, and had a fatality rate of about 40 percent.
Most H1N1 patients with respiratory failure treated with oxygenating system survive illness
Despite the severity of disease and the intensity of treatment, most patients in Australia and New Zealand who experienced respiratory failure as a result of 2009 influenza A(H1N1) and were treated with a system that adds oxygen to the patient's blood survived the disease.
Lessons learned from H1N1 virus pandemic
A comprehensive study has revealed, for the first time, the impact of swine flu on the health of the general public in Australia and New Zealand.
ADA publishes practice guidelines for nutrition care for patients with spinal cord injury
The American Dietetic Association has published new evidence-based nutrition practice guidelines for registered dietitians on nutrition care for patients with spinal cord injury.
Early mobilization of patients in ICU improves outcomes
Aside from the obvious and immediate health problems that patients undergoing mechanical ventilation face, those who recover often do so with profound loss of strength and mobility that can impair their daily functioning and even lead to increased risk of morbidity and mortality down the line.
Low vitamin D causes problems for acutely ill patients
A group of endocrinologists in Sydney have observed that very sick patients tend to have very low levels of Vitamin D. The sicker they are, the lower the levels.
In the ICU, use of benzodiazepines, other factors may predict severity of post-stay depression
Psychiatrists and critical care specialists at Johns Hopkins have begun to tease out what there is about a stay in an intensive care unit (ICU) that leads so many patients to report depression after they go home.
Targeting oxidized cysteine through diet could reduce inflammation and lower disease risk
A team of scientists at Emory University School of Medicine has identified a direct link between oxidative stress and inflammatory signals in the blood.
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