Hyperglycemia in the Critically Ill Patient
Hyperglycemia in the Critically Ill Patient
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DOI：
10.1097/00044067-200601000-00007
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发表时间：
2006-01-01
影响因子：
2.2
通讯作者：
Parbhoo, Shilpa K.
中科院分区：
文献类型：
--
作者：
Gearhart, Michelle M.;Parbhoo, Shilpa K.
高血糖和胰岛素抵抗在危重患者中很常见，在有或没有糖尿病病史的患者中都会发生。所有危重病人都有患应激性高血糖的风险。考虑到潜在的疾病状态和医源性因素，一些患者患高血糖的风险可能比其他患者更大。最近的许多研究表明，严格的血糖控制可以降低与危重疾病相关的发病率和死亡率。本文综述了应激性高血糖背后的病理生理机制，支持严格控制血糖的证据，以及强化胰岛素治疗方案在重症监护患者中标准化治疗的重要性。
Hyperglycemia and insulin resistance are common among critically ill patients and occur in patients with or without a history of diabetes mellitus. All patients undergoing critical illness are at risk for stress-induced hyperglycemia. Some patients may be at greater risk for hyperglycemia than others when considering underlying disease states and iatrogenic factors. Many recent studies demonstrate that tight glucose control can decrease morbidity and mortality associated with critical illness. This article reviews the pathophysiology behind stress-induced hyperglycemia, the evidence to support tight glycemic control, and the importance of an intensive insulin therapy protocol to standardize treatment among critical care patients.