Blood glucose changes in the process of continuous blood purification treatment and its clinical significance
10.3760/cma.j.issn.1008-6315.2010.11.017
- VernacularTitle:连续性肾脏替代治疗过程中血糖的变化及其临床意义
- Author:
Zhigang ZHANG
;
Bin SHI
;
Bin LI
;
Huaping WEI
- Publication Type:Journal Article
- Keywords:
Continuous renal replacement therapy;
Blood glucose;
Insulin;
Critically ill patients
- From:
Clinical Medicine of China
2010;26(11):1171-1173
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the blood glucose changes in critically ill patients taken continuous renal replacement therapy(CRRT)before treatment and at different time points after treatment. Methods Sixtyseven critically ill patients were enrolled in the study,of whom 13 cases were treated conventionally and assigned as pre-treatment control group,while the other 54 cases undertook CRRT were assigned as CRRT group. The CRRT group were further sub-divided into four groups according to CRRT time((CRRT time <6 h group(n = 18),CRRT time of 6 - 12 h group(n = 18),CRRT time > 12 h group(n = 18);or sub-divided into two groups according to circulating blood temperature(≤ 36. 5 ℃ group(n =27)and > 36. 5 ℃ group(n =27));or sub-divided into two groups by sugar substitute fluid replacement solution as the formula group(the standard level of sugar content was 6. 9 mmol/L(n = 27)and sugar-free replacement fluid group(n = 27);or sub-divided into two groups according to the Glasgow Coma score(GCS)(GCS ≤ 8 points group(n = 24)and GCS > 8 group(n = 30). Blood glucose level at different time points were measured. Results The longer CRRT cycle time,lower temperature,sugar substitute fluid replacement fluid worse GCS score corresponded to more dramatic blood glucose fluctuation at different time points in CRRT group,and it took longer time for them to recover to normal blood sugar level Conclusions During the CRRT process insulin secretion was suppressed and led to increase of blood sugar. In most cases the blood glucose returns to normal after CRRT treatment over time,but a small number of cases require clinical intervention.