医学
糖尿病
应激性高血糖
胰岛素
随机对照试验
中期分析
内科学
前瞻性队列研究
重症监护医学
麻醉
内分泌学
作者
Karen C. McCowen,Atul Malhotra,Bruce R. Bistrian
标识
DOI:10.1016/s0749-0704(05)70154-8
摘要
Stress hyperglycemia is common and likely to be associated with at least some of the same complications as hyperglycemia in true diabetes mellitus, such as poor wound healing and a higher infection rate. The predominant cause is the intense counterregulatory hormone and cytokine responses of critical illness, often compounded by excessive dextrose administration, usually as TPN. Although randomized data suggesting benefit of controlling hyperglycemia in hospitalized patients are paltry, prospective controlled trials are feasible and should be initiated. In the interim, the practice at the authors' institution is to use insulin to lower plasma glucose concentrations to a safe range of 150 mg/dL to 200 mg/dL in all patients.
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