Linked Life Data

18825791

Source:http://linkedlifedata.com/resource/pubmed/id/18825791

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
5
pubmed:dateCreated
2008-9-29
pubmed:abstractText
The prevalence of intensive insulin and restrictive blood use protocols in burn centers is unknown, which may be problematic as the combined impact of these therapies is to concomitantly increase the prevalence of anemia and hypoglycemia in intensive care unit patients. Such a development is important because point-of-care (POC) glucometers report erroneously high values in the presence of low hematocrit (HCT), potentially masking the presence of hypoglycemia. We hypothesized that most American Burn Association (ABA) verified burn centers have adopted intensive insulin therapy while simultaneously restricting blood transfusions potentially increasing risk of hypoglycemia. All ABA verified burn centers (N = 44) were contacted. Clinical practices regarding intensive insulin therapy, restrictive transfusion practices, and the use of POC glucometers were evaluated. Intensive insulin protocols were implemented at 73% of ABA centers (defined as upper glucose target of < or = 120 mg/dl) and POC glucometers measurement was nearly universal; 95% of ABA centers use them routinely. Anemia is prevalent in intensive care units and may be increasing because of recent changes in practice. Defined hemoglobin and HCT levels trigger blood transfusion at 84% of centers, and of these, 51% restrict transfusion to hemoglobin < 7 g/dl or HCT < 22%. Most ABA centers now use intensive insulin protocols, many in combination with restrictive transfusion strategies. The combination of a higher prevalence of hypoglycemia in the presence of near universal anemia is concerning, particularly given the pervasiveness of glucometer use among burn centers.
pubmed:grant
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:issn
1559-047X
pubmed:author
pubmed:issnType
Print
pubmed:volume
29
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
718-23
pubmed:dateRevised
2011-11-17
pubmed:meshHeading
pubmed:articleTitle
The impact of intensive insulin protocols and restrictive blood transfusion strategies on glucose measurement in American Burn Association (ABA) verified burn centers.
pubmed:affiliation
United States Army Institute of Surgical Research, Brooke Army Medical Center, San Antonio, TX, USA.
pubmed:publicationType
Journal Article, Research Support, U.S. Gov't, Non-P.H.S., Research Support, Non-U.S. Gov't, Research Support, N.I.H., Extramural