Tight blood glucose control a recommendation applicable to any critically ill patient 英文参考文献.docVIP
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Tight blood glucose control a recommendation applicable to any critically ill patient 英文参考文献
Available online /content/8/6/427
Commentary
Tight blood glucose control: a recommendation applicable to any
critically ill patient?
Philippe Devos1 and Jean-Charles Preiser2
1Resident, Department of Intensive Care, Centre Hospitalier Universitaire du Sart Tilman, Liege, Belgium
2Clinical Director, Department of Intensive Care, Centre Hospitalier Universitaire du Sart Tilman, Liege, Belgium
Corresponding author: Jean-Charles Preiser, Jean-Charles.Preiser@chu.ulg.ac.be
Published online: 27 October 2004
Critical Care 2004, 8:427-429 (DOI 10.1186/cc2989)
This article is online at /content/8/6/427
? 2004 BioMed Central Ltd
Related to Research by Vriesendorp et al., see page 513
Abstract
The issue of tight glucose control with intensive insulin therapy in critically ill patients remains
controversial. Although compelling evidence supports this strategy in postoperative patients who have
undergone cardiac surgery, the use of tight glucose control has been challenged in other situations,
including in medical critically ill patients and in those who have undergone non-cardiac surgery.
Similarly, the mechanisms that underlie the effects of high-dose insulin are not fully elucidated. These
arguments emphasize the need to study the effects of tight glucose control in a large heterogeneous
cohort of intensive care unit patients.
Keywords cardiac surgery, critically ill, hyperglycemia, insulin, metabolism
Until the end of the past millenium, relatively little attention was
given to control of blood sugar levels. In critically ill patients,
hyperglycaemia was considered to be physiological because it
results from the metabolic and hormonal changes that
accompany the stress response to injury. In most intensive care
units (ICUs), blood sugar was checked every 4–6 hours and
hyperglycaemia (defined as blood sugar levels 10–12 mmol/l
[180–216 mg/dl]) was corrected by subcutaneous or
intravenous insulin. The presence of pre-existing diabetes
mellit
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