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[Stress hyperglycemia and its control with insulin in critically ill patients: current evidence].

Abstract：

OBJECTIVE:To analyze the current evidence on glycemic control with insulin therapy in the critically ill. RECENT FINDINGS:Stress hyperglycemia in critically ill patients has been associated with increased morbidity and mortality. Furthermore, current evidence suggests that glucose variability has a predictive value for hospital mortality. Initially, the Leuven studies showed that intensive insulin therapy was capable of reducing the mortality among surgical and medical ICU patients. Nevertheless, this strategy significantly increases the incidence of severe hypoglycemia. Three important trials on glucose control have been published recently: the VISEP, the Glucontrol study and the NICE-SUGAR. They have shown that strict control of glycemia is associated with a higher incidence of mortality and severe hypoglycemia. Furthermore, according to a recent meta-analysis, intensive insulin therapy may be beneficial for patients admitted to a surgical ICU. Further studies should be able to address some queries about these results on glycemic control in the critically ill.

journal_name

Med Intensiva

journal_title

Medicina intensiva

authors

Manzanares W,Aramendi I

doi

10.1016/j.medin.2009.10.003

subject

Has Abstract

pub_date

2010-05-01 00:00:00

pages

273-81

issue

4

eissn

0210-5691

issn

1578-6749

pii

S0210-5691(09)00112-0

journal_volume

34

pub_type

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