tailieunhanh - Báo cáo y học: "A disparity between physician attitudes and practice regarding hyperglycemia in pediatric intensive care units in the United States: a survey on actual practice habits"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: A disparity between physician attitudes and practice regarding hyperglycemia in pediatric intensive care units in the United States: a survey on actual practice habits. | Preissig and Rigby Critical Care 2010 14 R11 http content 14 1 R11 c CRITICAL CARE RESEARCH Open Access A disparity between physician attitudes and practice regarding hyperglycemia in pediatric intensive care units in the United States a survey on actual practice habits Catherine M Preissig1 2 Mark R Rigby2 Abstract Introduction Hyperglycemia is common in critically ill patients and is associated with increased morbidity and mortality. Strict glycemic control improves outcomes in some adult populations and may have similar effects in children. While glycemic control has become standard care in adults little is known regarding hyperglycemia management strategies used by pediatric critical care practitioners. We sought to assess both the beliefs and practice habits regarding glycemic control in pediatric intensive care units ICUs in the United States US . Methods We surveyed 30 US pediatric ICUs from January to May 2009. Surveys were conducted by phone between the investigators and participating centers and consisted of a 22-point questionnaire devised to assess physician perceptions and center-specific management strategies regarding glycemic control. Results ICUs included a cross section ofcenters throughout the US. Fourteen out of 30 centers believe all critically ill hyperglycemic adults should be treated while 3 30 believe all critically ill children should be treated. Twenty-nine of 30 believe some subsets of adults with hyperglycemia should be treated while 20 30 believe some subsets of children should receive glycemic control. A total of 70 73 80 27 and 40 of centers believe hyperglycemia adversely affects outcomes in cardiac trauma traumatic brain injury general medical and general surgical pediatric patients respectively. However only six centers use a standard uniform approach to treat hyperglycemia at their institution. Sixty percent of centers believe hypoglycemia is more dangerous than hyperglycemia. Seventy percent listed fear of .