Oli Flower (yes, the same Oli Flower that you have seen scampering around the edges of S.I.N. meetings arranging recording equipment and whose podcasts you’ve been listening to on the ICN site) and Simon Finfer have recently published a review paper of where intensive care is up to on the grainy issue of glucose control in critically ill patients.They review the evolution of glycaemic control and offer several reasons as to why it has posed such a challenge. One of the highlights of the article is the issue of lack of accuracy of the commonly used point-of-care (bedside) glucometers, especially in hypoxic and anaemic patients, and how blood gas sample glucose analysis may be a better way to go. |
They also summarise the implications of glycaemic end-points and variability and the differences in outcomes for hyperglycaemic sub-populations.
If you need any further hints to go and read this article, it contains perrty much everything you should know about in order to provide a full answer to a written, viva or hot case question in the fellowship exam. It’s only 2 pages long and is an easy read.