Critical Illness, Metabolism Disorders
Conditions
Keywords
Glucose Gap, Metabolic Monitoring, Critically Ill Patients, Prognosis, Insulin Resistance
Brief summary
Metabolic monitoring is fundamental to guiding nutritional therapy in critically ill patients. Although indirect calorimetry is the established gold standard for measuring resting energy expenditure, its routine clinical use is constrained by practical challenges, including procedural complexity, time-intensive nature, significant cost, and limited feasibility in patients on advanced life support, such as extracorporeal membrane oxygenation (ECMO). Dysregulation of glucose metabolism is common in this population, characterized not only by absolute dysglycemia but also-and perhaps more critically-by impairments in the efficiency of glucose transport and utilization across the microcirculatory continuum (from arterial blood, through the interstitial space, to venous return). This study seeks to examine the relationship between novel dynamic metrics-such as the arterio-interstitial glucose gradient-and key clinical parameters, including energy expenditure, organ function, and patient outcomes. Our objective is to assess the utility of these measures as minimally invasive, real-time biomarkers of metabolic state in critical illness.
Detailed description
This prospective observational study aims to investigate the association between blood-interstitial fluid glucose concentration differences and resting energy expenditure, organ function, and clinical outcomes in critically ill patients, while also exploring potential factors influencing these glucose concentration differences.
Interventions
None listed
Sponsors
Chinese Medical Association
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Age≥ 18 years and \< 80 years * ICU stay ≤48 hours * Expected ICU stay \> 24 hours * APACHE II score≥ 8
Exclusion criteria
* local infection within the sensor placement area * Laparotomy within lower abdomen * Participated in this study before * In other clinical trails
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| ICU Mortality | From date of study enrollment until the date of ICU discharge or date of death from any cause, whichever came first, assessed up to 60 days | The incidence of all-cause death during the patient's stay in the Intensive Care Unit |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Duration of Vasopressor Dependency | From date of study enrollment until the date of vasopressor cessation for at least 24 hours, assessed up to 30 days | The total length of time a patient requires continuous intravenous vasoactive drugs to maintain adequate blood pressure. |
| Duration of Invasive Mechanical Ventilation | From date of study enrollment until the date of successful extubation, tracheostomy, or death from any cause, whichever came first, assessed up to 30 days | The total length of time a patient requires endotracheal intubation and support from a mechanical ventilator. |
| Duration of Continuous Renal Replacement Therapy (CRRT) | From date of study enrollment until the date of CRRT discontinuation for at least 24 hours or death from any cause, whichever came first, assessed up to 30 days | The total length of time a patient requires continuous renal replacement therapy for acute kidney injury. |
Countries
China
Outcome results
None listed