Hyperglycemia as an indicator of neurological severity and outcome in patients with diffuse axonal injury / 中华神经医学杂志

Objective This study aimed to better examine the relationship between hyperglycemia and outcome after traumatic diffuse axonal injury (TDAI). Methods We prospectively studied 118patients with moderate or severe TDAI [Glasgow Coma Scale scores (GCS), 3～12] who were treated conservatively in the surgical intensive care unit of zhuhai hospital between January 2000 and December 2004. Serum glucose, GCS and Glasgow Outcome Scale (GOS) of all the patients were measured: serum glucose, GCS score was recorded on admission, on days 3, 7 and 2 weeks; Outcome was determined by GOS score at discharge and after 3 months , respectively and the data were analyzed statistically to determine the relationship between serum glucose levels, severity of injury, and neurological outcome.Results Patients who died had significantly higher admission serum glucose values than those patients who survived (230 mg/dL vs 130 mg/dL, P＜0.005). Admission serum glucose ≥210 mg/dL was uniformly associated with a worse outcome. Conclusion Early hyperglycemia is a significant indicator of its severity, and a reliable predictor of outcome to TDAI.

Effects of intensive insulin treatment on the prognosis of severe multiple trauma patients / 中华急诊医学杂志

16 and the distribution of severe trauma more than 2 anatomic parts.They were randomly divided into two groups:intensive insulin treatment group(n=31)and control group(n=31).Intensive insulin treatment group received insulin with insulin pump in order to maintain blood glucose levels at 4.0-6.1 mol/L,while the control group received routine insulin treatment in order to mmaintain blood glucose levels at 10.0- 11.0 mol/L.Plasma levels of TNF-?,IL-1,IL-6, CRP,APACHEⅡscores and cure rate were analyzed before and after the treatment.Data was expressed as mean?standard deviation.Two- tailed T test and ANOVA were used for comparison in SPSS 10.0,and changes were considered as statistically significant if P value was less than 0.05.Results After the intensive insulin treatment, patient's hemodynamic parameter apparently improved,APACHEⅡscores descended,and the levels of TNF-?, Ib-1,IL-6,CRP all declined,in comparison with control group,there were significant differences. Intensive insulin treatment might improve patient's general condition and decrease complications and mortality of severe multiple trauma.