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Understanding glycemic control in the critically ill: 2011 update.
Hosp Pract (1995). 2011 Apr; 39(2):47-55.HP

Abstract

Intensive monitoring of blood glucose concentrations in critically ill patients has become a standard of care in intensive care units over the past 10 years, following the publication of a single-center randomized trial targeting euglycemia in postoperative patients. This article summarizes the literature describing the relationship between hyperglycemia and mortality in the critically ill, the main findings of the major interventional trials of intensive insulin therapy, the association between hypoglycemia and increased glycemic variability with adverse outcomes, and the impact of a preexisting diagnosis of diabetes. A framework for understanding dysglycemia in the critically ill, an approach that recognizes disturbances in the "3 domains" of glycemic control--hyperglycemia, hypoglycemia, and increased glycemic variability--is presented. Finally, practical considerations relating to the implementation of glycemic management protocols are discussed.

Authors+Show Affiliations

Division of Critical Care, Stamford Hospital, Stamford, CT 06902, USA. jkrinsley@stamhealth.org

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

21576897

Citation

Krinsley, James S.. "Understanding Glycemic Control in the Critically Ill: 2011 Update." Hospital Practice (1995), vol. 39, no. 2, 2011, pp. 47-55.
Krinsley JS. Understanding glycemic control in the critically ill: 2011 update. Hosp Pract (1995). 2011;39(2):47-55.
Krinsley, J. S. (2011). Understanding glycemic control in the critically ill: 2011 update. Hospital Practice (1995), 39(2), 47-55. https://doi.org/10.3810/hp.2011.04.394
Krinsley JS. Understanding Glycemic Control in the Critically Ill: 2011 Update. Hosp Pract (1995). 2011;39(2):47-55. PubMed PMID: 21576897.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Understanding glycemic control in the critically ill: 2011 update. A1 - Krinsley,James S, PY - 2011/5/18/entrez PY - 2011/5/18/pubmed PY - 2011/8/10/medline SP - 47 EP - 55 JF - Hospital practice (1995) JO - Hosp Pract (1995) VL - 39 IS - 2 N2 - Intensive monitoring of blood glucose concentrations in critically ill patients has become a standard of care in intensive care units over the past 10 years, following the publication of a single-center randomized trial targeting euglycemia in postoperative patients. This article summarizes the literature describing the relationship between hyperglycemia and mortality in the critically ill, the main findings of the major interventional trials of intensive insulin therapy, the association between hypoglycemia and increased glycemic variability with adverse outcomes, and the impact of a preexisting diagnosis of diabetes. A framework for understanding dysglycemia in the critically ill, an approach that recognizes disturbances in the "3 domains" of glycemic control--hyperglycemia, hypoglycemia, and increased glycemic variability--is presented. Finally, practical considerations relating to the implementation of glycemic management protocols are discussed. SN - 2154-8331 UR - https://www.unboundmedicine.com/medline/citation/21576897/Understanding_glycemic_control_in_the_critically_ill:_2011_update_ L2 - https://medlineplus.gov/hyperglycemia.html DB - PRIME DP - Unbound Medicine ER -