Hyperglycemia in the critically ill.

摘要: Hyperglycemia is frequently seen in acutely ill patients and has historically been viewed as a normal response to stress. Treatment often not initiated unless blood glucose exceeds 200 250 mg/dL. Recent evidence suggests that hyperglycemia associated with worse outcomes within the population of medical surgical intensive care units. this develops from increased gluconeogenesis insulin resistance. Although specific mechanisms by which contributes poor are yet unknown, disruption mitochondrial respiration, direct toxicity, accumulation asymmetric dimethylarginine, impairment immune cell function among possibilities implicated. Studies demonstrate therapy achieve euglycemia reduces mortality morbidity critically patients. In addition recognizing treating hyperglycemia, it important identify other overlooked factors contribute such medications, intravenous fluids, enteral parenteral nutrition.