Case discussion in blood XXXX variability.

@entity1 @entity204 @entity4854 @entity413 @entity130
Stress-induced @entity4854 has been associated with poor outcomes and @entity204 in critically ill @entity1 . Blood @entity413 (BG) variability, a component of stress-related @entity4854 has recently been reported as a significant independent predictor of intensive care unit and hospital mortality. We sought to evaluate three cases in which intensive insulin therapy was administered using a standardized insulin dosing protocol to normalize the BG and reduce glycemic variability. Point-of-care BG values and other clinical measures were obtained from the medical record of three @entity1 who received intensive insulin therapy. This was a convenience sample of three @entity1 where the BG level had stabilized on a consistent intravenous insulin dose rate for up to 20 hours in a surgical @entity130 intensive care unit. Data were collected manually and electronically using the Remote Automated Laboratory System-Tight Glycemic Control Module (RALS-TGCM) BG management and monitoring system. Each case presentation describes a critically ill, nondiabetic @entity1 , requiring continuous intravenous insulin therapy for @entity4854 . In each instance, BG variability was present in a worsening @entity1 condition after a period of normalization of @entity4854 with intensive insulin therapy. Although decreasing BG variability is an important aspect of @entity4854 management, new onset events of variability may be a sentinel warning or occur as a physiologic response to a worsening @entity1 condition. If so, these events warrant rapid investigation and treatment of the underlying problem.
