Blog
About

4
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      A systematic scoping review on the consequences of stress-related hyperglycaemia

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Stress-related hyperglycaemia (SHG) is commonly seen in acutely ill patients and has been associated with poor outcomes in many studies performed in different acute care settings. We aimed to review the available evidence describing the associations between SHG and different outcomes in acutely ill patients admitted to an ICU. Study designs, populations, and outcome measures used in observational studies were analysed.

          Methods

          We conducted a systematic scoping review of observational studies following the Joanna Briggs methodology. Medline, Embase, and the Cochrane Library were searched for publications between January 2000 and December 2015 that reported on SHG and mortality, infection rate, length of stay, time on ventilation, blood transfusions, renal replacement therapy, or acquired weakness.

          Results

          The search yielded 3,063 articles, of which 43 articles were included (totalling 536,476 patients). Overall, the identified studies were heterogeneous in study conduct, SHG definition, blood glucose measurements and monitoring, treatment protocol, and outcome reporting. The most frequently reported outcomes were mortality (38 studies), ICU and hospital length of stay (23 and 18 studies, respectively), and duration of mechanical ventilation (13 studies). The majority of these studies (40 studies) compared the reported outcomes in patients who experienced SHG with those who did not. Fourteen studies (35.9%) identified an association between hyperglycaemia and increased mortality (odds ratios ranging from 1.13 to 2.76). Five studies identified hyperglycaemia as an independent risk factor for increased infection rates, and one identified it as an independent predictor of increased ICU length of stay.

          Discussion

          SHG was consistently associated with poor outcomes. However, the wide divergences in the literature mandate standardisation of measuring and monitoring SHG and the creation of a consensus on SHG definition. A better comparability between practices will improve our knowledge on SHG consequences and management.

          Related collections

          Most cited references 77

          • Record: found
          • Abstract: not found
          • Article: not found

          Scoping studies: towards a methodological framework

            Bookmark
            • Record: found
            • Abstract: found
            • Article: found
            Is Open Access

            Scoping studies: advancing the methodology

            Background Scoping studies are an increasingly popular approach to reviewing health research evidence. In 2005, Arksey and O'Malley published the first methodological framework for conducting scoping studies. While this framework provides an excellent foundation for scoping study methodology, further clarifying and enhancing this framework will help support the consistency with which authors undertake and report scoping studies and may encourage researchers and clinicians to engage in this process. Discussion We build upon our experiences conducting three scoping studies using the Arksey and O'Malley methodology to propose recommendations that clarify and enhance each stage of the framework. Recommendations include: clarifying and linking the purpose and research question (stage one); balancing feasibility with breadth and comprehensiveness of the scoping process (stage two); using an iterative team approach to selecting studies (stage three) and extracting data (stage four); incorporating a numerical summary and qualitative thematic analysis, reporting results, and considering the implications of study findings to policy, practice, or research (stage five); and incorporating consultation with stakeholders as a required knowledge translation component of scoping study methodology (stage six). Lastly, we propose additional considerations for scoping study methodology in order to support the advancement, application and relevance of scoping studies in health research. Summary Specific recommendations to clarify and enhance this methodology are outlined for each stage of the Arksey and O'Malley framework. Continued debate and development about scoping study methodology will help to maximize the usefulness and rigor of scoping study findings within healthcare research and practice.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Intensive insulin therapy in critically ill patients.

              Hyperglycemia and insulin resistance are common in critically ill patients, even if they have not previously had diabetes. Whether the normalization of blood glucose levels with insulin therapy improves the prognosis for such patients is not known. We performed a prospective, randomized, controlled study involving adults admitted to our surgical intensive care unit who were receiving mechanical ventilation. On admission, patients were randomly assigned to receive intensive insulin therapy (maintenance of blood glucose at a level between 80 and 110 mg per deciliter [4.4 and 6.1 mmol per liter]) or conventional treatment (infusion of insulin only if the blood glucose level exceeded 215 mg per deciliter [11.9 mmol per liter] and maintenance of glucose at a level between 180 and 200 mg per deciliter [10.0 and 11.1 mmol per liter]). At 12 months, with a total of 1548 patients enrolled, intensive insulin therapy reduced mortality during intensive care from 8.0 percent with conventional treatment to 4.6 percent (P<0.04, with adjustment for sequential analyses). The benefit of intensive insulin therapy was attributable to its effect on mortality among patients who remained in the intensive care unit for more than five days (20.2 percent with conventional treatment, as compared with 10.6 percent with intensive insulin therapy, P=0.005). The greatest reduction in mortality involved deaths due to multiple-organ failure with a proven septic focus. Intensive insulin therapy also reduced overall in-hospital mortality by 34 percent, bloodstream infections by 46 percent, acute renal failure requiring dialysis or hemofiltration by 41 percent, the median number of red-cell transfusions by 50 percent, and critical-illness polyneuropathy by 44 percent, and patients receiving intensive therapy were less likely to require prolonged mechanical ventilation and intensive care. Intensive insulin therapy to maintain blood glucose at or below 110 mg per deciliter reduces morbidity and mortality among critically ill patients in the surgical intensive care unit.
                Bookmark

                Author and article information

                Contributors
                Role: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: Funding acquisitionRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: Funding acquisitionRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                6 April 2018
                2018
                : 13
                : 4
                Affiliations
                [1 ] PHMR Ltd, London, United Kingdom
                [2 ] Nestlé Health Science, Vevey, Switzerland
                [3 ] Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
                Azienda Ospedaliero Universitaria Careggi, ITALY
                Author notes

                Competing Interests: PHMR was commissioned by Nestlé Health Science to perform this research. In collaboration with Nestlé Health Science, PHMR wrote the scoping review’s protocol, designed the search strategy and eligibility criteria, performed the study selection, charted the data and summarised the results. A protocol was not registered for this systematic scoping review as PROSPERO currently does not accept systematic scoping review protocols (personal communication). All authors had full access to the data. All authors had final responsibility for the decision to submit for publication. At the time of writing, EO and NP were permanent employees of PHMR; AD and MM are permanent employees of Nestlé Health Science; J-CP has received honoraria for speeches and consultancy fees from Nestlé (Vevey, Switzerland). This does not alter our adherence to PLOS ONE policies on sharing data and materials.

                Article
                PONE-D-17-44491
                10.1371/journal.pone.0194952
                5889160
                29624594
                © 2018 Olariu et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                Counts
                Figures: 2, Tables: 1, Pages: 15
                Product
                Funding
                Funded by: Nestlé Health Science
                PHMR was commissioned by Nestlé Health Science to perform this research. In collaboration with Nestlé Health Science, PHMR wrote the scoping review’s protocol, designed the search strategy and eligibility criteria, performed the study selection, charted the data and summarised the results. A protocol was not registered for this systematic scoping review as PROSPERO currently does not accept systematic scoping review protocols (personal communication). All authors had full access to the data. All authors had final responsibility for the decision to submit for publication. At the time of writing, EO and NP were permanent employees of PHMR; AD and MM are permanent employees of Nestlé Health Science; J-CP has received honoraria for speeches and consultancy fees from Nestlé (Vevey, Switzerland).
                Categories
                Research Article
                Biology and Life Sciences
                Population Biology
                Population Metrics
                Death Rates
                Medicine and Health Sciences
                Health Care
                Health Care Facilities
                Hospitals
                Intensive Care Units
                Medicine and Health Sciences
                Hematology
                Bloodstream Infections
                Medicine and Health Sciences
                Urology
                Urinary Tract Infections
                Medicine and Health Sciences
                Endocrinology
                Endocrine Disorders
                Diabetes Mellitus
                Medicine and Health Sciences
                Metabolic Disorders
                Diabetes Mellitus
                Biology and Life Sciences
                Anatomy
                Body Fluids
                Blood
                Blood Sugar
                Medicine and Health Sciences
                Anatomy
                Body Fluids
                Blood
                Blood Sugar
                Biology and Life Sciences
                Physiology
                Body Fluids
                Blood
                Blood Sugar
                Medicine and Health Sciences
                Physiology
                Body Fluids
                Blood
                Blood Sugar
                Medicine and Health Sciences
                Endocrinology
                Diabetic Endocrinology
                Insulin
                Biology and Life Sciences
                Biochemistry
                Hormones
                Insulin
                Medicine and Health Sciences
                Diagnostic Medicine
                Clinical Laboratory Sciences
                Transfusion Medicine
                Blood Transfusion
                Medicine and Health Sciences
                Hematology
                Transfusion Medicine
                Blood Transfusion
                Custom metadata
                All data generated or analysed during this study are included in this published article and S1 and S2 Tables.

                Uncategorized

                Comments

                Comment on this article