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Gestión de la glucosa en la UCI: El estudio de cohorte bicéntrico GEM-UCI
Milda Grigonyte-Daraskeviciene1, Ruben Julius Eck2, Morten Hylander Møller1,3
1Department of Intensive Care, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
Acta anaesthesiologica Scandinavica
|February 20, 2026
Resumen
La hipoglucemia fue poco común en pacientes de la unidad de cuidados intensivos (UCI), pero la hiperglucemia fue frecuente. El uso de insulina era común, sin embargo, los pacientes a menudo permanecían por encima de los niveles de glucosa objetivo.
Área de la Ciencia:
- Medicina de cuidados críticos Medicina de cuidados críticos.
- Endocrinología Endocrinología.
- Química clínica es la química clínica.
Sus antecedentes:
- La disglucemia es prevalente en pacientes de la unidad de cuidados intensivos (UCI), correlacionándose con resultados adversos.
- Existen datos contemporáneos limitados sobre el manejo de la glucosa y el uso de insulina en UCI.
Objetivo del estudio:
- Para investigar el control de la glucosa y los patrones de administración de insulina en pacientes en estado crítico.
- Evaluar la incidencia de hipoglucemia e hiperglucemia en el entorno de la UCI.
Principales métodos:
- Un estudio de cohorte retrospectivo bi-central de 300 pacientes adultos de UCI admitidos de forma aguda.
- Datos recopilados de registros electrónicos de salud, incluidos los niveles de glucosa en sangre y la administración de insulina.
- Resultado primario: hipoglucemia; resultados secundarios: hipoglucemia severa, hiperglucemia, tiempo dentro o por encima del rango objetivo, mortalidad y resultados de días vivos.
Principales resultados:
- La hipoglucemia ocurrió en el 7,4% de los pacientes; la hipoglucemia grave en el 1,1%.
- Se observó hiperglucemia en el 65,3% de los pacientes.
- La mortalidad a los treinta días fue del 24,3%; la mediana de días vivos sin soporte vital (DAWOLS) fue de 27; la mediana de días vivos fuera del hospital (DAOH) fue de 9.
Conclusiones:
- La hipoglucemia es poco común, mientras que la hiperglucemia es frecuente en pacientes daneses de UCI.
- La administración de insulina es común, pero lograr el control objetivo de la glucosa sigue siendo un desafío.
- Se justifica una mayor investigación para optimizar las estrategias de gestión de la glucosa en UCI.
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