Development of Pneumonia Due to Alveolar Glucose Levels in Systemic Hyperglycemia

University of Ulm

Status: Unknown

Conditions: Glucose Metabolism Disorders; Pneumonia, Bacterial

Treatments: Diagnostic Test: Glucose Measurements,

Study type: Observational

Funder types: Other

Identifiers

NCT03577964

267/17

Details and patient eligibility

About

Incidence of Pneumonia in Patients with high systemic glucose levels.

Full description

Clinical and mechanistic studies have shown that a hyperglycaemic metabolic condition is associated with a higher incidence of infection and consecutive increased morbidity and mortality. The underlying mechanisms in detail are not completely understood. So far it is not clear whether systemic increased glucose levels are caused by a stress reaction of the body through a catabolic metabolism situation as well as a "stress-induced insulin resistance", or infections are promoted by hyperglycemia. From in vivo and in vitro studies, a glucose threshold for the lung is known (147 mg / dL), similar to that in the kidney. It can be hypothesized, that an intra-alveolar glucose in turn promotes bacterial growth as a nutrient substrate. The aim of the study is to determine the concentration of glucose in the alveolar space in connection with hyperglycemic conditions, and to demonstrate a higher incidence of pneumonia in this patient group. The study will enroll cardiac surgery patients receiving surgical treatment and expected postoperative ventilation. Systemic blood glucose monitoring is recorded throughout hospitalization, as well as the removal of bronchial aspirates intraoperatively and during ventilation to measure glucose levels and bacterial levels. The incidence of pneumonia is recorded during the postoperative period by means of radiological examinations and / or microbiological examinations.

Enrollment: 61 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• women and men over the age of 18 years
• voluntary consent to study participation of the patient
• Planned cardiac surgery with expected endotracheal ventilation of ≥ 1 day postoperatively

Exclusion criteria

• age <18 years
• pregnancy
• Non-able-bodied patients (disempowerment / loss of consciousness, limitation of the ability to express one's own will, for example through disability)
• subsequently withdrawn consent
• accommodation in an institution on the basis of official or court orders
• lack of or insufficient knowledge of German language, whereby the understanding of the written patient education is not guaranteed.
• Immunosuppressed patients
• Patients with a malignant disease

Trial design