1. Prone positioning is associated with increased insulin requirements in mechanically ventilated patients with COVID-19
- Author
-
Harry Griffiths, Amy Cardwell, Max Richardson, Meg Barne, Bogdan Petrisor, Ammara Usman, Laura Heales, Julia Calvo Latorre, Vishakha Bansiya, Razeen Mahroof, Tamas Szakmany, Daniel Martin, Anthony Rostron, Andrew Conway Morris, and Sam Lockhart
- Subjects
COVID-19 ,Prone ventilation ,Glucose metabolism ,Insulin ,Critical illness ,Medicine ,Science - Abstract
Abstract Stress hyperglycaemia is common in critical illness. We have previously observed that increasing severity of respiratory failure in patients with severe COVID-19 is associated with increased insulin demand. Given previously reported direct effects of hypoxia on insulin action, we reasoned that rapid improvements in oxygenation following prone positioning may improve insulin sensitivity and increase risk of hypoglycaemia. A retrospective multi-centre service evaluation comparing blood glucose and insulin administration in patients with COVID-19 pneumonitis receiving prone mechanical ventilation, comparing the 16 h pre-prone and 16 h post-prone time periods. 155 patients were included in this analysis. Oxygenation improved significantly following prone positioning (change in SpO2/FIO2 per hour prone: 3.01 ± 0.14, P
- Published
- 2024
- Full Text
- View/download PDF