Hyperglycemia and perioperative glucose management.

摘要: Hyperglycemia is associated with increased mortality and morbidity in critically ill patients. Surgical patients commonly develop hyperglycemia related to the hypermetabolic stress response, which increases glucose production causes insulin resistance. Although worse outcomes, treatment of infusions has not provided consistent benefits. Despite early results, suggested decreased other advantages "tight" control, later investigations found either no benefit or when was aggressively treated insulin. Because these conflicting data, optimal concentration improve outcomes unknown. There agreement, however, that hypoglycemia an undesirable complication intensive therapy should be avoided. In addition, risk variability recognized, because for outcomes. Patients diabetes mellitus experience chronic often require more perioperative management. When diabetic are evaluated before surgery, appropriate management oral hypoglycemic agents necessary as several warrant special consideration. Current recommendations from national societies varied, but, most suggest tight control may beneficial, while mild appears well-tolerated.