Effect of glucose management levels on the incidence of systemic inflammatory response syndrome (SIRS) in intensive care

Abstract

AbstractBackground: Systemic inflammatory response syndrome (SIRS) is an excessive defence reaction of the body to a noxious stressor (infection, trauma, surgery, acute inflammation, ischemia or reperfusion, or cancer, to name a few) to pinpoint and then eradicate the endogenous or external source of the insult. Even while the cytokine storm serves a defence role, it can trigger a huge inflammatory cascade that results in reversible or permanent end-organ failure and even death.Objective: The regulation of glucose levels in ICU patients is intimately connected to the occurrence of SIRS. Also to investigate the effect of glucose management level on the incidence of systemic inflammatory response syndrome (SIRS) in intensive care.Methods: The study was carried out on 200 patients who were admitted to our hospital's intensive care unit (ICU) for treatment. Inclusion and exclusion criteria were recorded. According to their blood glucose control levels, they were separated into 3 groups. After 28 days following ICU admission, differences in serum inflammation level, blood glucose level, SIRS incidence, and death rate were compared.Results: On the first day, there were no considerable variations in HR, RR, or T across the 3 groups. Only on the 7th day statistically significant variations (P<0.05) were observed in group C. Group A's average blood glucose level was substantially reduced than groups B and C. Group A had much greater hypoglycemia than groups B andC. Insulin levels were substantially greater in groups A and B than in group C. Group A had a considerably reduced duration of stay and mechanical ventilation time than groups B and C. CRP, IL-6, TNF-, and insulin levels did not differ significantly between groups A and B. Group C had a considerably higher incidence of SIRS, MODS, and 28-day mortality. Group C had a high prevalence of nosocomial infection than groups A and B, while group B had a higher incidence than group A. The differences were statistically significant (P<0.05), and the logistic results showed that blood glucose levels and insulin dosage were risk factors for SIRS incidence (P0.05). Conclusion: Active control of blood glucose levels in ICU patients is beneficial to reduce the incidence of SIRS, according to the standard range. [Ethiop. J. Health Dev.2022;36(3):00-00]Keywords: Blood glucose; Intensive care unit; Systemic inflammatory response syndrome; incidence rate