Blood glucose control in the trauma patient.
Hyperglycemia can be a significant problem in the trauma population and has been shown to be associated with increased morbidity and mortality. Hyperglycemia in the trauma patient, as in other critically ill patients, is caused by a hypermetabolic response to stress and seems to be an entity of its own rather than simply a marker. Although several early studies in a mixed intensive care unit population indicated that insulin protocols aimed at strict glucose control improved outcome, later studies did not support this and, in fact, encountered increased complications due to hypoglycemia. More recent studies in the trauma population, while supporting the correlation between hyperglycemia and increased mortality, seemed to indicate that protocols aimed at moderate glucose control improved outcome while limiting the incidence of hypoglycemic complications.
Eakins
James
J
Department of Surgery, Cooper University Hospital, The Robert Wood Johnson Medical School-University of Medicine and Dentistry, New Jersey, Camden, New Jersey 08103, USA. james.eakins@tenethealth.com
D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism; D001930:Brain Injuries / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D002056:Burns / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D003422:Critical Care; D016638:Critical Illness; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D007003:Hypoglycemia / Q000097:blood / Q000139:chemically induced / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D007328:Insulin / Q000008:administration & dosage* / Q000009:adverse effects; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin