James S Krinsley

Learn More
OBJECTIVE To assess the effect of an intensive glucose management protocol in a heterogeneous population of critically ill adult patients. PATIENTS AND METHODS This study consisted of 800 consecutive patients admitted after institution of the protocol (treatment group, between February 1, 2003, and January 10, 2004) and 800 patients admitted immediately(More)
OBJECTIVE To investigate the relationship between hyperglycemia and hospital mortality in a heterogeneous group of critically ill patients. PATIENTS AND METHODS Retrospective data were reviewed for 1826 consecutive patients whose glucose values were obtained during their intensive care unit stay at The Stamford Hospital in Stamford, Conn, between October(More)
OBJECTIVE To determine the risk factors for development of severe hypoglycemia (defined as glucose <40 mg/dL) in critically ill patients and define the outcomes of this complication. DESIGN Retrospective database review, including a case-control analysis that matched each patient with severe hypoglycemia with three controls. SETTING Adult intensive care(More)
OBJECTIVES To determine the effect of glycemic variability, assessed by the standard deviation of each patient's mean glucose level, on mortality in a population of critically ill adult patients. DESIGN Retrospective review of a large cohort of prospectively evaluated patients. SETTING Fourteen-bed medical surgical adult intensive care unit of a(More)
The management reporting and assessment of glycemic control lacks standardization. The use of different methods to measure the blood glucose concentration and to report the performance of insulin treatment yields major disparities and complicates the interpretation and comparison of clinical trials. We convened a meeting of 16 experts plus invited observers(More)
Achieving adequate glucose control in critically ill patients is a complex but important part of optimal patient management. Until relatively recently, intermittent measurements of blood glucose have been the only means of monitoring blood glucose levels. With growing interest in the possible beneficial effects of continuous over intermittent monitoring and(More)
BACKGROUND Glycemic variability (GV) has recently been associated with mortality in critically ill patients. The impact of diabetes or its absence on GV as a risk factor for mortality is unknown. METHODS A total of 4084 adult intensive care unit (ICU) patients admitted between October 15, 1999, and June 30, 2009, with at least three central laboratory(More)
Hyperglycemia occurs commonly in acutely and critically ill patients and has been associated with adverse clinical consequences. An emerging body of literature describes the beneficial effects of intensive glycemic monitoring and treatment (tight glycemic control, or "TGC"). This manuscript reviews the experience of a cohort of 5365 non-cardiac surgery(More)
OBJECTIVE To evaluate the literature and identify important aspects of insulin therapy that facilitate safe and effective infusion therapy for a defined glycemic end point. METHODS Where available, the literature was evaluated using Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) methodology to assess the impact of insulin(More)