References of "Preiser, Jean-Charles"
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See detailGestion de l'hyperglycémie au cours de la nutrition parentérale
DE FLINES, Jenny ULg; PAQUOT, Nicolas ULg; PREISER, Jean-Charles ULg

in Nutrition Clinique et Metabolisme (2012), 26(3), 143-147

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See detailVariability of insulin sensitivity during the first 4 days of critical illness: implications for tight glycemic control
Pretty, Christopher ULg; Le Compte, Aaron J.; Chase, J. Geoffrey et al

in Annals of Intensive Care (2012)

Introduction: Effective tight glycaemic control (TGC) can improve outcomes in critical care patients, but is difficult to achieve consistently. Insulin sensitivity defines the metabolic balance between ... [more ▼]

Introduction: Effective tight glycaemic control (TGC) can improve outcomes in critical care patients, but is difficult to achieve consistently. Insulin sensitivity defines the metabolic balance between insulin concentration and insulin mediated glucose disposal. Hence, variability of insulin sensitivity can cause variable glycaemia. This study quantifies and compares the daily evolution of insulin sensitivity level and variability for critical care patients receiving TGC. <br /> <br />Methods: A retrospective analysis of data from the SPRINT TGC study involving patients admitted to a mixed medical-surgical ICU between August 2005 and May 2007. Only patients who commenced TGC within 12 hours of ICU admission and spent at least 24 hours on the SPRINT protocol were included (N=164). Model-based insulin sensitivity (SI) was identified each hour. Absolute level and hour-to-hour percent changes in SI were assessed on cohort and per-patient bases. Levels and variability of SI were compared over time on 24-hour and 6-hour timescales for the first 4 days of ICU stay. <br /> <br />Results: Cohort and per-patient median SI levels increased by 34% and 33% (p<0.001) between days 1 and 2 of ICU stay. Concomitantly, cohort and per-patient SI variability decreased by 32% and 36% (p<0.001). For 72% of the cohort, median SI on day 2 was higher than on day 1. The day 1-2 results are the only clear, statistically significant trends across both analyses. <br /> <br />Analysis of the first 24 hours using 6-hour blocks of SI data showed that most of the improvement in insulin sensitivity level and variability seen between days 1 and 2 occurred during the first 12-18 hours of day 1. <br /> <br />Conclusions: Critically ill patients have significantly lower and more variable insulin sensitivity on day 1 than later in their ICU stay and particularly during the first 12 hours. This rapid improvement is likely due to the decline of counter-regulatory hormones as the acute phase of critical illness progresses. Clinically, these results suggest that while using TGC protocols with patients during their first few days of ICU stay, extra care should be afforded. Increased measurement frequency, higher target glycaemic bands, conservative insulin dosing and modulation of carbohydrate nutrition should be considered to safely minimize outcome glycaemic variability and reduce the risk of hypoglycaemia. [less ▲]

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See detailDoes Tight Glycemic Control positively impact on patient mortality?
Penning, Sophie ULg; Le Compte, Aaron J.; Signal, Matthew et al

Poster (2012, March 20)

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See detailEvolution de l’insulino-résistance au cours de l’hypothermie thérapeutique
Moermans, A; Taccone, F; Penning, Sophie ULg et al

in Proceedings des journees francophone de nutrition 2012 (2012)

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See detailCumulative time in band (cTIB): glycemic level, variability and patient outcome vs mortality
Penning, Sophie ULg; Signal, M; PREISER, Jean-Charles ULg et al

in Proceedings of ANZICS 2012 (2012)

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See detailVariability of insulin sensitivity during the first 4 days of critical illness
Pretty, Christopher ULg; Le Compte, A; Chase, JG et al

in Critical Care (2012), 16 (Suppl 1)

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See detailObservation of incretin effects during enteral feed transitions of critically ill patients
Jamaludin, U. K.; Docherty, P. D.; Geoffrey Chase, J. et al

in e-SPEN Journal (2012), 7(4), 154-159

Background & aims: Critically ill patients are regularly feed via constant enteral (EN) nutrition infusions. However, the incretin effect or its impact on endogenous insulin concentration remains unclear ... [more ▼]

Background & aims: Critically ill patients are regularly feed via constant enteral (EN) nutrition infusions. However, the incretin effect or its impact on endogenous insulin concentration remains unclear. This study determines whether there is an EN-driven incretin effect in critically ill patients requiring glycaemic control. Methods: Clinically validated, model-based time-variant insulin sensitivity (S I) profiles were identified for 52 non-diabetic patients on Specialized Relative Insulin Nutrition Titration (SPRINT) glycaemic control during transitions off EN (ON/OFF), and back on to EN (OFF/ON). Incretin effects were observable via increased modelled S I after the OFF/ON transition or a decreased S I after the ON/OFF transition. Results: Patients exhibited a median -36% (IQR -82% to 24% p = 0.001) reduction after the ON/OFF feed transition, and a median of +32% (IQR -5% to 53%, p = 0.05) rise in measured S I after the OFF/ON transition. However, 32% of patients exhibited increased S I at the OFF/ON transition, and 37% exhibited reduced S I at the ON/OFF transition. The results are likely due to changes in patient condition over the 5-8 h considered outweighing this effect. Blood glucose was the same during both transitions with median shifts of -2% and -3% after the ON/OFF, and OFF/ON transitions (p > 0.5), respectively. Conclusions: Results imply a significant incretin effect is observed at a cohort level. The impact was stronger for the OFF/ON transition indicating that this effect may be blunted by long-term continuous EN infusions. These results provide the data to design conclusive studies, and to inform glycaemic control protocol development and implementation. © 2012 European Society for Clinical Nutrition and Metabolism. [less ▲]

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See detailValidation of a Virtual Patient and Virtual Trials Method for Accurate Prediction of TGC Protocol Performance
Suhaimi, Fatanah; Le Compte, Aaron; Penning, Sophie ULg et al

Poster (2011, March)

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See detailEnhanced insulin sensitivity variability in the first 3 days of ICU stay: Implications for TGC
Chase, Geoffrey; Le Compte, Aaron; Penning, Sophie ULg et al

Poster (2011, March)

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See detailObservation of the Incretin Effect in Critically Ill patients
Jamaludin, U.; Docherty, P; Chase, JG et al

in Proceedings of the 11th Annual Diabetes Technology Meeting (DTM2011) (2011)

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See detailEnteral nutrition-associated incretin effect in the critically ill
PREISER, Jean-Charles ULg; Jamaludin, U; Docherty, P et al

in Proceedings of the 33rd Congress of Clinical Nutrition and Metabolism (ESPEN 2011) (2011)

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See detailPilot Trials of the STAR TGC Protocol in a Cardiac Surgery ICU
LeCompte, Aaron J.; Penning, Sophie ULg; Moorhead, Katherine ULg et al

in Proceedings of the 10th Annual Diabetes Technology Meeting (2010, November)

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See detailWhy Protocolised care works in my unit?
Shaw, GM; Chase, JG; Pfeiffer, L et al

in Proceedings of the Australia-New Zealand Intensive Care Society Scientific Meeting (ANZICS 2010) (2010)

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See detailTight Glycaemic control and nutrition: A comparison of two protocols
Suhaimi, F; Le Compte, AJ; PREISER, Jean-Charles ULg et al

in Proceedings of the Centre for Bio-Engineering One Day Conference 2010 (2010)

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See detailValidation of a virtual trial method for tight glycemic control in intensive care
Suhaimi, F; Chase, JG; PREISER, Jean-Charles ULg et al

in Proceedings of the Health Research Society of Canterbury (HRSC) Clinical Meeting 2010 (2010)

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See detailThe critical role of carbohydrate administration in safe, effective TGC
PREISER, Jean-Charles ULg; Suhaimi, F; Chase, JG et al

in Clinical Nutrition (2010), 5 (Suppl 2):111

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See detailOrgan failure and tight glycemic control in the SPRINT study.
Chase, J Geoffrey; Pretty, Christopher G; Pfeifer, Leesa et al

in Critical Care (2010), 14(4), 154

INTRODUCTION: Intensive care unit mortality is strongly associated with organ failure rate and severity. The sequential organ failure assessment (SOFA) score is used to evaluate the impact of a successful ... [more ▼]

INTRODUCTION: Intensive care unit mortality is strongly associated with organ failure rate and severity. The sequential organ failure assessment (SOFA) score is used to evaluate the impact of a successful tight glycemic control (TGC) intervention (SPRINT) on organ failure, morbidity, and thus mortality. METHODS: A retrospective analysis of 371 patients (3,356 days) on SPRINT (August 2005 - April 2007) and 413 retrospective patients (3,211 days) from two years prior, matched by Acute Physiology and Chronic Health Evaluation (APACHE) III. SOFA is calculated daily for each patient. The effect of the SPRINT TGC intervention is assessed by comparing the percentage of patients with SOFA </=5 each day and its trends over time and cohort/group. Organ-failure free days (all SOFA components </=2) and number of organ failures (SOFA components >2) are also compared. Cumulative time in 4.0 to 7.0 mmol/L band (cTIB) was evaluated daily to link tightness and consistency of TGC (cTIB >/=0.5) to SOFA </=5 using conditional and joint probabilities. RESULTS: Admission and maximum SOFA scores were similar (P = 0.20; P = 0.76), with similar time to maximum (median: one day; IQR: 13 days; P = 0.99). Median length of stay was similar (4.1 days SPRINT and 3.8 days Pre-SPRINT; P = 0.94). The percentage of patients with SOFA </=5 is different over the first 14 days (P = 0.016), rising to approximately 75% for Pre-SPRINT and approximately 85% for SPRINT, with clear separation after two days. Organ-failure-free days were different (SPRINT = 41.6%; Pre-SPRINT = 36.5%; P < 0.0001) as were the percent of total possible organ failures (SPRINT = 16.0%; Pre-SPRINT = 19.0%; P < 0.0001). By Day 3 over 90% of SPRINT patients had cTIB >/=0.5 (37% Pre-SPRINT) reaching 100% by Day 7 (50% Pre-SPRINT). Conditional and joint probabilities indicate tighter, more consistent TGC under SPRINT (cTIB >/=0.5) increased the likelihood SOFA </=5. CONCLUSIONS: SPRINT TGC resolved organ failure faster, and for more patients, from similar admission and maximum SOFA scores, than conventional control. These reductions mirror the reduced mortality with SPRINT. The cTIB >/=0.5 metric provides a first benchmark linking TGC quality to organ failure. These results support other physiological and clinical results indicating the role tight, consistent TGC can play in reducing organ failure, morbidity and mortality, and should be validated on data from randomised trials. [less ▲]

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