The optimal target of acute glycemic control to prevent ICU-acquired weakness

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K09394
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 55060:Emergency medicine-related
• Research Institution: Kobe University
• Principal Investigator: Egi Moritoki 神戸大学, 医学研究科, 准教授 (20423296)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Keywords: ICU-acquired weakness / 重症患者 / 血糖

Outline of Final Research Achievements

This prospective observational study was designed to identify optimal acute glycemic control to prevent diffuse muscle weakness (ICU-acquired weakness) associated with critical illness.
From year of 2019 to 2021, 75 critically ill patients who required mechanical ventilation, expected to require long-term intensive care, were consented to have their HbA1c levels measured at ICU admission and to have their blood glucose measured continuously using FreeStyle Libre and iPro. Each glycemic control index was calculated from both methods. Then, muscle atrophy was evaluated in each patient. We determine the presence or absence of ICUAW with echo analysis and muscle damage markers. Further analyses will be performed according to a statistical plan.

Free Research Field

集中治療

Academic Significance and Societal Importance of the Research Achievements

ICUAW発症と有意な関連を示す血糖指標を検討する研究の多くは後ろ向き観察研究であり、その大半の研究において、血糖値は多くのリスク因子候補の中の一つに過ぎず、詳細な検討はなされていない。本研究は持続血糖測定器を用いることで詳細な急性期血糖推移の情報を集め、血糖管理を中心に解析を行うことを目的とした前向き観察研究であり、世界的にみても類を見ない研究である。
本研究によって、ICUAWに最も関連する血糖指標が明らかになることで、ICUAWの発症予防における急性期血糖管理において、もっとも留意すべき点がわかれば、新たな急性期血糖管理法の提唱が可能となる可能性がある。