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- Title
Factors determining the appearance of glucose in upper and lower respiratory tract secretions.
- Authors
Philips, Barbara J.; Meguer, Jean-Xavier; Redman, Jonathan; Baker, Emma H.
- Abstract
<bold>Objectives: </bold>(a). To describe the glucose content of normal human airways secretions; (b). to observe the effects of hyperglycemia and airways inflammation on airways glucose.<bold>Design: </bold>Observational studies.<bold>Settings: </bold>(a). St George's Hospital Medical School; (b). diabetes mellitus outpatient clinics; (c). adult general intensive care unit.<bold>Patients: </bold>Nineteen healthy volunteers, 24 volunteers with acute rhinitis, 20 patients with diabetes mellitus, and 60 patients admitted to a general adult intensive care unit.<bold>Measurements: </bold>(a). Non-ventilated patients: simultaneous measurement of blood and nasal glucose concentrations; (b). ICU patients: simultaneous blood, nasal, and endotracheal (ET) glucose concentrations.<bold>Results: </bold>Nasal glucose was undetectable in all healthy volunteers. Glucose was detected in 12/24 volunteers with acute viral rhinitis [1 (1-2) mmol l(-1)] and 18/20 people with diabetes [4 (2-7) mmol l(-1)]. Glucose was detected in the ET secretions of 31/60 ventilated patients on ICU. Patients with ET glucose had significantly higher blood glucose (9.8+/-0.4 mmol l(-1)) than patients without ET glucose (7.2+/-0.3 mmol l(-1), P<0.001), and all patients with blood glucose >10.1 mmol l(-1) had glucose in ET secretions. Enteral nutrition did not affect the presence or concentration of glucose in ET secretions.<bold>Conclusions: </bold>Glucose is not normally present in airways secretions, but appears where hyperglycaemia or epithelial inflammation occur. The detection of glucose cannot reliably be used to detect enteral feed aspiration.
- Subjects
RESPIRATORY obstructions; HYPERGLYCEMIA; AIRWAY (Anatomy); LUNG congestion; CRITICAL care medicine; MOBILE intensive care units; OUTPATIENT medical care; GLUCOSE metabolism; BLOOD sugar; INTENSIVE care units; NASAL mucosa; TYPE 2 diabetes; RESPIRATORY infections; RHINITIS; SMOKING; CASE-control method
- Publication
Intensive Care Medicine, 2003, Vol 29, Issue 12, p2204
- ISSN
0342-4642
- Publication type
journal article
- DOI
10.1007/s00134-003-1961-2