Benefits and methods of achieving strict glycemic control in the ICU.
Hyperglycemia, a frequent complication in critically ill patients, has been shown to have a negative influence on morbidity and mortality. Many factors contribute to hyperglycemia, including the stress response, diabetes, obesity, advanced age, corticosteroids, sepsis, pancreatitis, and the use of nutrition support. Application of intensive insulin therapy, when compared with conventional glycemic control measures, seems to improve outcomes in the critically ill patient. Therefore, effective insulin therapy along with appropriate nutrition support prescriptions provide a means for the critical care nurse and other health care team members to lower complications and enhance recovery in the ICU setting.
Roberts
Susan R
SR
Nutrition Services, Baylor University Medical Center, 3500 Gaston Avenue, Dallas, TX 75246, USA. susanro@baylorhealth.edu
Hamedani
Bahar
B
D015190:Blood Glucose Self-Monitoring; D003422:Critical Care / Q000379:methods* / Q000592:standards; D016638:Critical Illness; D048909:Diabetes Complications / Q000150:complications; D016903:Drug Monitoring / Q000379:methods / Q000451:nursing; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008991:Monitoring, Physiologic / Q000379:methods / Q000451:nursing; D024802:Nurse's Role; D018529:Nutritional Support / Q000009:adverse effects / Q000379:methods / Q000592:standards; D009765:Obesity / Q000150:complications; D010289:Parenteral Nutrition, Total / Q000379:methods / Q000592:standards; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D013312:Stress, Physiological / Q000150:complications / Q000378:metabolism; D014945:Wound Healing; D014947:Wounds and Injuries / Q000150:complications / Q000378:metabolism
D007004:Hypoglycemic Agents; D007328:Insulin