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Essay On Glycemic Control

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Kramer, Roberts, and Zygun (2012) conducted a level I systematic review and meta-analysis of randomized controlled trials (RCTs) to assess whether tight glycemic control reduces mortality and improves outcomes in neurocritical care patients. A thorough search was conducted through Ovid interface, MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), and the Cochrane Database of Systematic Reviews. The search terms used were: “intensive glycemic control”, “neurocritical care”, and “clinical trials”. After the initial search, 3,040 references were identified. However, only sixteen studies were included. These sixteen studies involved 1,248 patients total, 654 patients treated with intensive glycemic control vs. 594…show more content…
Secondary outcomes included: hypoglycemia with the threshold at 60 mg/dL, nosocomial pneumonia, and other nosocomial infections. Kramer et al. concluded that intensive glycemic control did not reduce mortality in neurocritical patients. However, nurses implementing tight glycemic control reduces the occurrence of poor neurological outcomes. Poor glycemic control should be avoided at all costs since it proves to be harmful. Therefore, the use of moderate glycemic control is recommended because intensive glycemic control can cause severe cases of hypoglycemia (Kramer et al., 2012).
There were numerous limitations to the study; there was heterogeneity in the provision and reporting of nutritional supplementation, which may have influenced the results (Kramer et al., 2012). In implementing findings, nurses must closely monitor blood glucose levels in the intensive care unit. Due to the findings of this systematic review, nurses should implement moderate glycemic control to reduce the mortality rate in ICUs (Kramer et al., 2012).
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Egi et al. (2016) conducted a level II multicenter, multinational, retrospective observational study to study the impact of pre-morbid glycemic control on the association between acute hypoglycemia in intensive care unit patients and subsequent hospital mortality in critically ill patients. The study took place in hospitals in the United States of America, Japan, and Australia. All adult patients admitted into
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