[Metabolic control in the critically ill patient an update: hyperglycemia, glucose variability hypoglycemia and relative hypoglycemia]

Cir Cir. 2017 Jan-Feb;85(1):93-100. doi: 10.1016/j.circir.2016.10.026. Epub 2016 Dec 18.
[Article in Spanish]

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.

Objectives: 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.

Keywords: Control de la glucemia; Glucose variability; Glycemic control; Hiperglucemia; Hipoglucemia; Hyperglycemia; Hypoglycemia; Variabilidad de la glucosa.

Publication types

  • Review

MeSH terms

  • Adaptation, Physiological
  • Blood Glucose / analysis
  • Clinical Trials as Topic
  • Critical Care / methods*
  • Critical Illness / therapy*
  • Disease Management
  • Energy Metabolism
  • Gluconeogenesis
  • Hormones / metabolism
  • Humans
  • Hyperglycemia / drug therapy*
  • Hyperglycemia / epidemiology
  • Hyperglycemia / etiology
  • Hyperglycemia / physiopathology
  • Hypoglycemia / drug therapy*
  • Hypoglycemia / epidemiology
  • Hypoglycemia / etiology
  • Hypoglycemia / physiopathology
  • Hypoglycemic Agents / administration & dosage
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use
  • Insulin / administration & dosage
  • Insulin / adverse effects
  • Insulin / therapeutic use
  • Multicenter Studies as Topic
  • Multiple Organ Failure / etiology
  • Multiple Organ Failure / prevention & control

Substances

  • Blood Glucose
  • Hormones
  • Hypoglycemic Agents
  • Insulin