Document Detail


Hypoglycemia and strict glycemic control in critically ill patients.
MedLine Citation:
PMID:  18614902     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: In contrast to patients with diabetes mellitus, data on consequences of hypoglycemia in critically ill patients are sparse. The purpose of this review is to summarize available data on prevalence of hypoglycemia, risk factors, and possible consequences of hypoglycemia in critically ill patients. RECENT FINDINGS: There is strong evidence that strict glycemic control is beneficial for critically ill patients. Recent attempts to confirm these findings have not succeeded. Instead, they have increased the fear for negative consequences of hypoglycemia. Hypoglycemia is four to seven times more frequent in patients treated with strict glycemic control. Risk factors for hypoglycemia are a change in nutrition without adjustment of insulin treatment, diabetes mellitus, sepsis, shock, liver failure, and the need for renal replacement therapy. Consequences of hypoglycemia in critically ill patients are not well defined, but overall current evidence suggests that beneficial effects of strict glycemic control outweigh possible negative effects of hypoglycemia. SUMMARY: Hypoglycemia should be avoided in critically ill patients, but not at the cost of less stringent glycemic control. Strict glycemic control with a low incidence of hypoglycemia can be achieved with a validated (computerized) algorithm and increased surveillance in patients with an increased risk for hypoglycemia.
Authors:
Titia M Vriesendorp; J Hans DeVries; Joost B L Hoekstra
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in critical care     Volume:  14     ISSN:  1531-7072     ISO Abbreviation:  Curr Opin Crit Care     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-10     Completed Date:  2008-08-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9504454     Medline TA:  Curr Opin Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  397-402     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Academic Medical Center, Amsterdam, the Netherlands. t.m.vriesendorp@amc.uva.nl
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MeSH Terms
Descriptor/Qualifier:
Blood Glucose / analysis*
Critical Illness*
Glycemic Index
Humans
Hypoglycemia / prevention & control*
Intensive Care Units
Chemical
Reg. No./Substance:
0/Blood Glucose

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