The importance of insulin administration in the critical care unit.
In the last decade investigation into the importance of glucose control and insulin administration in a wide variety of clinical settings has occurred. In virtually all studies, whether of cardiac ischemia or bypass surgery, cerebrovascular recovery from ischemia or head injury, or surgical critical illness, intensive insulin therapy with tight glucose control has resulted in improved clinical outcomes by decreasing both morbidity and mortality. The fundamental biochemical mechanisms for these findings are increasingly well understood and explain the apparent far-reaching beneficial effects of this therapy. In the future, it is likely that all hospitalized surgical patients will have tight glucose control.
Lipsett
Pamela A
PA
Johns Hopkins University Schools of Medicine and Nursing, 600 North Wolfe Street, Blalock 685, Baltimore, MD 21287, USA. plipsett@jhmi.edu
D000818:Animals; D001786:Blood Glucose / Q000378:metabolism; D001026:Coronary Artery Bypass; D016638:Critical Illness; D003920:Diabetes Mellitus / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery; D004730:Endothelium, Vascular / Q000503:physiopathology; D004935:Esophageal Diseases / Q000601:surgery; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy* / Q000503:physiopathology; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D007362:Intensive Care Units; D007902:Length of Stay; D018805:Sepsis / Q000517:prevention & control
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin