[Assessment and treatment of hyperglycemia in critically ill patients].
Hyperglycemia is a commonly encountered issue in critically ill patients in the intensive care setting. The presence of hyperglycemia is associated with increased morbidity and mortality, regardless of the reason for admission (e.g., acute myocardial infarction, status post-cardiovascular surgery, stroke, sepsis). However, the pathophysiology and, in particular, the treatment of hyperglycemia in the critically ill patient remain controversial. In clinical practice, several aspects must be taken into account in the management of these patients, including blood glucose targets, history of diabetes mellitus, the route of nutrition (enteral or parenteral), and available monitoring equipment, which substantially increases the workload of providers involved in the patients' care. This review describes the epidemiology, pathophysiology, management, and monitoring of hyperglycemia in the critically ill adult patient.
Serviço de Terapia Intensiva, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brasil.
Marina Verçoza
MV
Viana
Serviço de Terapia Intensiva, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brasil.
Rafael Barberena
RB
Moraes
Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.
Amanda Rodrigues
AR
Fabbrin
Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.
Manoella Freitas
MF
Santos
Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.
Fernando
F
Gerchman
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000628:therapy*; D003920:Diabetes Mellitus / Q000453:epidemiology; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D007362:Intensive Care Units / Q000458:organization & administration; D018529:Nutritional Support / Q000379:methods; D016526:Workload
D001786:Blood Glucose