Factors determining the appearance of glucose in upper and lower respiratory tract secretions
Factors determining the appearance of glucose in upper and lower respiratory tract secretions
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DOI：
10.1007/s00134-003-1961-2
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发表时间：
2003-12-01
影响因子：
38.9
通讯作者：
Baker, EH
中科院分区：
文献类型：
--
作者：
Philips, BJ;Meguer, JX;Baker, EH
目标. (a)描述正常人气道分泌物的葡萄糖含量;（B）观察高血糖和气道炎症对气道葡萄糖的影响。设计观察性研究。设置. (a)圣乔治医院医学院;（B）糖尿病门诊诊所;（c）成人普通重症监护室。患者19名健康志愿者、24名急性鼻炎志愿者、20名糖尿病患者和60名入住普通成人重症监护室的患者。测量. (a)非通气患者：同时测量血液和鼻葡萄糖浓度;（B）ICU患者：同时测量血液、鼻和气管内（ET）葡萄糖浓度。结果在所有健康志愿者中均检测不到鼻葡萄糖。在12/24例急性病毒性鼻炎志愿者[1（1-2）mmol l（-1）]和18/20例糖尿病患者[4（2-7）mmol l（-1）]中检测到葡萄糖。在ICU的60例机械通气患者中，31例检测到ET分泌物中的葡萄糖。有ET葡萄糖的患者血糖（9.8 ± 0.4 mmol l（-1））显著高于无ET葡萄糖的患者（7.2 ± 0.3 mmol l（-1），P <10.1 mmol l（-1）。肠内营养不影响ET分泌物中葡萄糖的存在或浓度。结论.葡萄糖通常不存在于气道分泌物中，但出现在高血糖或上皮炎症发生的地方。葡萄糖的检测不能可靠地用于检测肠内喂养吸入。
Objectives. (a) To describe the glucose content of normal human airways secretions; (b) to observe the effects of hyperglycemia and airways inflammation on airways glucose. Design. Observational studies. Settings. (a) St George's Hospital Medical School; (b) diabetes mellitus outpatient clinics; (c) adult general intensive care unit. Patients. Nineteen healthy volunteers, 24 volunteers with acute rhinitis, 20 patients with diabetes mellitus, and 60 patients admitted to a general adult intensive care unit. Measurements. (a) Non-ventilated patients: simultaneous measurement of blood and nasal glucose concentrations; (b) ICU patients: simultaneous blood, nasal, and endotracheal (ET) glucose concentrations. Results. 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), P10.1 mmol l(-1) had glucose in ET secretions. Enteral nutrition did not affect the presence or concentration of glucose in ET secretions. Conclusions. 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.