原创力文档international recommendations for glucose control in adult non diabetic critically ill patients国际建议成人非糖尿病危重患者的血糖控制.pdfVIP
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international recommendations for glucose control in adult non diabetic critically ill patients国际建议成人非糖尿病危重患者的血糖控制
Ichai et al. Critical Care 2010, 14:R166
/content/14/5/R166
RESEARCH Open Access
International recommendations for glucose
control in adult non diabetic critically ill patients
1 2* 3
Carole Ichai , Jean-Charles Preiser , for the Société Française d’Anesthésie-Réanimation (SFAR) ,
Société de Réanimation de langue Française (SRLF) and the Experts group4
Abstract
Introduction: The purpose of this research is to provide recommendations for the management of glycemic
control in critically ill patients.
Methods: Twenty-one experts issued recommendations related to one of the five pre-defined categories (glucose
target, hypoglycemia, carbohydrate intake, monitoring of glycemia, algorithms and protocols), that were scored on
a scale to obtain a strong or weak agreement. The GRADE (Grade of Recommendation, Assessment, Development
and Evaluation) system was used, with a strong recommendation indicating a clear advantage for an intervention
and a weak recommendation indicating that the balance between desirable and undesirable effects of an
intervention is not clearly defined.
Results: A glucose target of less than 10 mmol/L is strongly suggested, using intravenous insulin following a
standard protocol, when spontaneous food intake is not possible. Definition of the severe hypoglycemia threshold
of 2.2 mmol/L is recommended, regardless of the clinical signs. A general, unique amount of glucose (enteral/
parenteral) to administer for any patient cannot be suggested. Glucose measurements should be performed on
arterial rather than venous or capillary samples, using central lab or blood gas analysers rather than point-of-care
glucose readers.
Conclusions: Thirty recommendations were obtained
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