On of GLUT1 and GLUT3 is upregulated and GLUT2 expression is
On of GLUT1 and GLUT3 is upregulated and GLUT2 expression is normal in prolonged critical illness, a constellation that may predispose cells to FT011 chemical information glucose overload and toxicity, and that can be beneficially affected by intensive insulin therapy. Expression of GLUT4, by far the most dominantly expressed transporter in muscle, is low in the critically ill and is normalized by intensive insulin therapy. Together, these findings may offer an explanation for the high vulnerability to glucose toxicity during critical illness and how intensive insulin therapy may prevent this. Reference 1. Van den Berghe G, et al.: N Engl J Med 2001, 345:1359.P254 Continuous glucose monitoring using the SCGM1 system in postcardiothoracic surgery patientsJ Plank1, R Schaller2, M Ellmerer1, D Koller2, R Eberhardt2, G K ler1, M Shoemaker3, K Obermaier3, W Toller1, T Pieber1, L Schaupp2 1Medical University Graz, Austria; 2Joanneum Research, Graz, Austria; 3Roche Diagnostics, Mannheim, Germany Critical Care 2006, 10(Suppl 1):P254 (doi: 10.1186/cc4601) Background and aims Tight glycaemic control (TGC) has proven to reduce mortality and morbidity in critically ill patients. However, in many ICUs implementation of TGC in daily practice is still suboptimal due to the risk of hypoglycaemia and the increased work demands for the ICU nursing staff. Continuous glucose monitoring (CGM) in the interstitial fluid (ISF) might be an alternative to improve the adjustment of insulin therapy without causing additional workload. The aim of the study was to investigate CGM in the ISF in ICU patients using a microdialysisbased monitoring system. Materials and methods Twenty patients (male/female: 15/5; age 69 ?7 years, nondiabetics/diabetics: 14/6; BMI 28.2 ?4.9 kg/m2, APACHE II score: 11.0 ?3.5) with a glucose level higher than 6.7 mmol/l were investigated in ICU after cardiothoracic surgery. ASAvailable online http://ccforum.com/supplements/10/Smicrodialysis catheter (CMA 60), which is part of the SCGM1 system (Roche Diagnostics, Mannheim, Germany), was inserted into the subcutaneous adipose tissue of the abdomen. In all patients, arterial PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/25447644 glucose was measured hourly to describe the glucose profile until the end of the ICU stay, but for a maximum period of 48 hours. Results The mean duration of glucose monitoring was 36 ?15 hours. Eighteen out of 20 data could be analysed (two systems were excluded due to technical failure of the system). The mean blood glucose value was 7.2 ?1.4 mmol/l (130 ?25 mg/dl). The mean Pearson correlation coefficient between blood and the SCGM1 system reading was rBG-SCGM = 0.808. In addition the correlation for different calibration intervals (6?2?4 hours) of the SCGM1 system was quantified with several evaluation methods (method of residuals, modified error grid analysis [mEGA], predicted error sum of the squares [ PRESS], mean absolute difference [MAD], coefficient of correlation).Table 1 (abstract P254) 6 hours Mean of residuals System error ( ) PRESS ( ) MAD ( ) EGA, A B ( ) 0.17 2.49 12.52 0.76 99.86 12 hours 0.30 4.03 15.64 1.27 99.86 24 hours 0.31 3.97 18.29 2.71 98.placed on the patients’ thumb, where it performed NI continuous measurements for up to 24 hours, with readings every 10?5 min. The PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/28549975 results obtained from the NBM-100 device were compared with arterial blood samples taken through an arterial line every 30?0 min and analyzed with a blood gas machine (ABL 700; Radiometer, Copenhagen, Denmark). Results A prospective analysis based on a unifor.

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