Glucose management in critically ill adults and children
Glucose management in critically ill adults and children
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DOI：
10.1016/s2213-8587(15)00223-5
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发表时间：
2015-09-01
影响因子：
44.5
通讯作者：
Kosiborod, Mikhail
中科院分区：
文献类型：
--
作者：
Mesotten, Dieter;Preiser, Jean-Charles;Kosiborod, Mikhail
急性心肌梗死和危重病患者的血糖管理一直备受争议。与2001年之前不重视血糖管理的时代相比，1995年的DIGAMI-1和2001年的第一项鲁汶研究显示，严格控制血糖可改善结局，从而表明高血糖与死亡风险之间存在因果关系。这些具有里程碑意义的试验在临床实践中设定了标准，即过度高血糖是不可接受的。多中心试验与严格控制患者血糖的益处相矛盾，结果表明血糖控制的不同标准操作程序（例如血糖仪或算法）、不同的伴随喂养策略和不同的患者人群是重要的混杂因素。目前的普遍共识是过度高血糖（>10 mmol/L）和严重低血糖（
Blood glucose management in people with acute myocardial infarction and critical illness has always attracted controversy. Compared with the era before 2001 when no attention was given to blood glucose management, DIGAMI-1 in 1995 and the first Leuven study in 2001 showed improved outcomes with strict control of blood glucose, thereby suggesting a causal association between hyperglycaemia and mortality risk. These landmark trials have set the standard in clinical practice that excessive hyperglycaemia is not acceptable. Multicentre trials contradicted the benefits of tight control of patients' blood glucose and results showed that different standard operating procedures for blood glucose control (eg, blood glucose meters or algorithms), divergent concomitant feeding strategies, and varying patient populations are important confounders. The general consensus now is that excessive hyperglycaemia (>10 mmol/L) and severe hypoglycaemia (