title: [Metabolic control in the critically ill patient an update: hyperglycemia, glucose variability hypoglycemia and relative hypoglycemia].
abstract: BACKGROUND
  Metabolic changes of glucose in critically ill patients increase morbidity and mortality. The appropriate level of blood glucose has not been established so far and should be adjusted for different populations. However concepts such as glucose variability and relative hypoglycemia of critically ill patients are concepts that are changing management methods and achieving closer monitoring.
  
  
  OBJECTIVE
  The purpose of this review is to present new data about the management and metabolic control of patients in critical areas.
  
  
  CONCLUSIONS
  Currently glucose can no longer be regarded as an innocent element in critical patients; both hyperglycemia and hypoglycemia increase morbidity and mortality of patients. Protocols and better instruments for continuous measurement are necessary to achieve the metabolic control of our patients.
authors.affiliation: Unidad de Terapia Intensiva de Ginecología y Obstetricia, Hospital General de México «Dr. Eduardo Liceaga», Ciudad de México, México. Electronic address: gmemiinv@gmail.com.
authors.forename: Ángel Augusto
authors.initials: ÁA
authors.lastname: Pérez-Calatayud
authors.affiliation: Unidad de Terapia Intensiva, Hospital Central Sur de Alta Especialidad PEMEX, Ciudad de México, México.
authors.forename: Ariadna
authors.initials: A
authors.lastname: Guillén-Vidaña
authors.affiliation: Urgencias, Hospital Juárez de México, Ciudad de México, México.
authors.forename: Irving Santiago
authors.initials: IS
authors.lastname: Fraire-Félix
authors.affiliation: Unidad de Terapia Intensiva de Ginecología y Obstetricia, Hospital General de México «Dr. Eduardo Liceaga», Ciudad de México, México.
authors.forename: Eduardo Daniel
authors.initials: ED
authors.lastname: Anica-Malagón
authors.affiliation: Unidad de Terapia Intensiva de Ginecología y Obstetricia, Hospital General de México «Dr. Eduardo Liceaga», Ciudad de México, México.
authors.forename: Jesús Carlos
authors.initials: JC
authors.lastname: Briones Garduño
authors.affiliation: División de Áreas Críticas, Instituto Nacional de Rehabilitación, Ciudad de México, México.
authors.forename: Raúl
authors.initials: R
authors.lastname: Carrillo-Esper
mesh_terms: D000222:Adaptation, Physiological; D001786:Blood Glucose / Q000032:analysis; D002986:Clinical Trials as Topic; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000628:therapy*; D019468:Disease Management; D004734:Energy Metabolism; D005943:Gluconeogenesis; D006728:Hormones / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D007003:Hypoglycemia / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D015337:Multicenter Studies as Topic; D009102:Multiple Organ Failure / Q000209:etiology / Q000517:prevention & control
chemical_list: D001786:Blood Glucose; D006728:Hormones; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Control de la glucemia; Glucose variability; Glycemic control; Hiperglucemia; Hipoglucemia; Hyperglycemia; Hypoglycemia; Variabilidad de la glucosa