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Hyperglycemia during critical illness.

Stanley A Nasraway1

  • 1Department of Surgery, Tufts-New England Medical Center, Boston, Massachusetts 02111, USA. Snasraway@tufts-nemc.org

JPEN. Journal of Parenteral and Enteral Nutrition
|April 28, 2006
PubMed
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Tight glycemic control in critically ill patients, particularly through intensive insulin therapy, improves outcomes by reducing complications. This approach benefits both diabetic and nondiabetic individuals, highlighting the importance of managing blood glucose levels.

Area of Science:

  • Critical care medicine
  • Endocrinology
  • Metabolic disorders

Background:

  • Hyperglycemia is prevalent in critically ill patients.
  • Elevated blood glucose is linked to increased severity of illness and adverse outcomes, primarily due to infectious complications.

Purpose of the Study:

  • To review existing literature on the benefits of tight glycemic control in critically ill patients.
  • To compare outcomes in different subgroup populations receiving intensive glycemic management.

Main Methods:

  • A comprehensive literature search was conducted using PubMed.
  • The search focused on studies related to hyperglycemia and its management within the intensive care unit (ICU) setting.

Main Results:

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  • Evidence strongly supports that hyperglycemia indicates illness severity and independently predicts poor outcomes, especially infectious complications.
  • Intensive insulin therapy for euglycemic control is beneficial in critically ill patients, with potential greater benefits observed in nondiabetic individuals.
  • Protocolized approaches are effective in achieving euglycemia and minimizing hypoglycemia; further research is needed on specific glycemic targets for patient subpopulations.

    • Conclusions:

    • Hyperglycemia is a significant predictor of mortality and complications in critically ill patients.
    • Controlling hyperglycemia through intensive management strategies demonstrably improves patient outcomes.
    • Ongoing research aims to further clarify the benefits and optimal strategies for tight glycemic control in intensive care settings.