Palabras clave
Glucemia
Cuidados críticos
Insulina
Infusiones parenterales
Protocolos clínicos
Cuidados críticos
Insulina
Infusiones parenterales
Protocolos clínicos
Cómo citar
Arias-Amaya, A. M., Castellanos-Bueno, R., Rangel-Rivera, D. A., & Pinto-Arias, A. J. (2020). Aspectos clínicos del tratamiento de la hiperglucemia no complicada en la unidad de cuidados intensivos. Médicas UIS, 33(2), 49–54. https://doi.org/10.18273/revmed.v33n2-2020006
Resumen
Introducción: la glucosa es una variable dinámica en el paciente crítico. La hiperglucemia (mayor a 140 mg/dL) es frecuente en este grupo de pacientes, existiendo distintos enfoques terapéuticos para el control adecuado de la misma. Objetivo: revisar los aspectos clínicos de la glucemia y la importancia del control glucémico en el paciente crítico adulto. Metodología de búsqueda: en base de datos Pubmed, utilizando los términos MeSH: “critical illness”, “insulin infusion”, “insulin protocol”, “hyperglycemia”. Se incluyeron artículos de revisión y originales, en inglés y español. Conclusiones: el manejo de la hiperglucemia en el paciente crítico es un objetivo primordial en el enfoque integral del paciente de la unidad de cuidados intensivos, dada su asociación con mortalidad, morbilidad y estancia hospitalaria. MÉD. UIS.2020;33(2): 49-54.
Referencias
Gunst J, De Bruyn A, Van den Berghe G. Glucose control in the ICU. Curr Opin Anaesthesiol. 2019;32(2): 156–162.
American Diabetes Association. Primary Care - Standards of Medical Care in Diabetes. Diabetes Care. 2020;43(Suppl. 1):S1– 212.
Kumar S, Molitch ME. Use of Insulin in the Inpatient Setting: Need for Continued Use. Curr Diab Rep. 2019;19(9):64.
Lansang MC, Umpierrez GE. Inpatient hyperglycemia management: A practical review for primary medical and surgical teams. Cleve Clin J Med. 2016;83 (5 Suppl.):S34–43.
Moghissi ES, Korytkowski MT, DiNardo M, Einhorn D, Hellman R, Hirsch IB, et al. American Association of Clinical Endocrinologists and American Diabetes Association Consensus Statement on Inpatient Glycemic Control. Diabetes Care. 2009;32(6):1119–1131.
Umpierrez GE, Isaacs SD, Bazargan N, You X, Thaler LM, Kitabchi AE. Hyperglycemia: An independent marker of inhospital mortality in patients with undiagnosediabetes. J Clin Endocrinol Metab. 2002;87(3):978–982.
Cook CB, Kongable GL, Potter DJ, Abad VJ, Leija DE, Anderson M. Inpatient glucose control: a glycemic survey of 126 U.S. hospitals. J Hosp Med. 2009;4(9):E7–14.
Figueroa CL, Suárez FC, Ochoa AF, Rengifo LJ, Isaza JR. Hemoglobina glicosilada y eventos cardiovasculares en pacientes diabéticos de un hospital universitario. Acta Med Colomb. 2018; 43(2): 74–80.
Silva-Perez LJ, Benitez-Lopez MA, Varon J, Surani S. Management of critically ill patients with diabetes. World J Diabetes. 2017;8(3):89-96.
Falciglia M, Freyberg RW, Almenoff PL, D’Alessio DA, Render ML. Hyperglycemia-related mortality in critically ill patients varies with admission diagnosis. Crit Care Med. 2009;37(12):3001–9.
Krinsley JS. Association Between Hyperglycemia and Increased Hospital Mortality in a Heterogeneous Population of Critically Ill Patients. Mayo Clin Proc. 2003;78(12):1471–8.
Badawi O, Waite MD, Fuhrman SA, Zuckerman IH. Association between intensive care unit–acquired dysglycemia and inhospital mortality. Crit Care Med. 2012;40(12):3180–8.
Carpenter DL, Gregg SR, Xu K, Buchman TG, Coopersmith CM. Prevalence and Impact of Unknown Diabetes in the ICU. Crit Care Med. 2015;43(12):e541–550.
van Vught LA, Wiewel MA, Klein Klouwenberg PMC, Hoogendijk AJ, Scicluna BP, Ong DSY, et al. Admission Hyperglycemia in Critically Ill Sepsis Patients: Association With Outcome and Host Response. Crit Care Med. 2016;44(7):1338–1346.
Krikorian A, Ismail-Beigi F, Moghissi ES. Comparisons of different insulin infusion protocols: a review of recent literature. Curr Opin Clin Nutr Metab Care. 010;13(2):198–204.
Van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, et al. Intensive Insulin Therapy in Critically Ill Patients. N Engl J Med. 001;345(19):1359–1367.
Gill G V., Woodward A, Casson IF, Weston PJ. Cardiac arrhythmia and nocturnal hypoglycaemia in type 1 diabetes--the “dead in bed” syndrome revisited. Diabetologia. 009;52(1):42–5.
Krinsley JS. Effect of an Intensive Glucose Management Protocol n the Mortality of Critically Ill Adult Patients. Mayo Clin Proc. 2004;79(8):992–1000.
Preiser J-C, Devos P, Ruiz-Santana S, Mélot C, Annane D, Groeneveld J, et al. A prospective randomised multi-centre controlled trial on tight glucose control by ntensive insulin therapy in adult intensive care units: the Glucontrol study. Intensive Care Med. 2009;35(10):1738–1748.
Krinsley JS, Grover A. Severe hypoglycemia in critically ill patients: risk factors and outcomes. Crit Care Med. 2007;35(10):2262–7.
Griesdale DEG, de Souza RJ, van Dam RM, Heyland DK, Cook DJ, Malhotra A, et al. Intensive insulin therapy and mortality among critically ill patients: a meta-analysis including NICE-SUGAR study data. CMAJ. 2009;180(8):821-7.
Van den Berghe G, Wilmer A, Hermans G, Meersseman W, Wouters PJ, Milants I, et al. Intensive Insulin Therapy in the Medical ICU. N Engl J Med. 2006;354(5):449–61.
Chase JG, Pretty CG, Pfeifer L, Shaw GM, Preiser JC, Le Compte AJ, et al. Organ failure and tight glycemic control in the SPRINT study. Crit Care. 2010;14(4): R154.
Brunkhorst FM, Engel C, Bloos F, Meier-Hellmann A, Ragaller M, Weiler N, et al. Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med. 2008;358(2):125–39.
Finfer S, Bellomo R, Blair D, Su SYS, Foster D, Dhingra V, et al. Intensive versus conventional glucose control in critically Ill patients. N Engl J Med. 2009;360(13):1283–97.
Wiener RS, Wiener DC, Larson RJ. Benefits and risks of tight glucose control in critically ill adults: a meta-analysis. JAMA. 2008;300(8):933-44.
Umpierrez G, Cardona S, Pasquel F, Jacobs S, Peng L, Unigwe M, et al. Randomized controlled trial of intensive versus conservative glucose control in patients undergoing coronary artery bypass graft surgery: GLUCOCABG trial. Diabetes Care. 2015;38(9):1665–72.
Egi M, Bellomo R, Stachowski E, French CJ, Hart GK, Taori G, et al. The interaction of chronic and acute glycemia with mortality in critically ill patients with diabetes. Crit Care Med. 2011;39(1):105–11.
Krinsley JS, Egi M, Kiss A, Devendra AN, Schuetz P, Maurer PM, et al. Diabetic status and the relation of the three domains of glycemic control to mortality in critically ill patients: An international multicenter cohort study. Crit Care. 2013;17(2): R37.
Marik PE, Egi M. Treatment thresholds for hyperglycemia in critically ill patients with and without diabetes. Intensive Care Med. 2014; 40(7): 1049–51.
Krinsley JS, Maurer P, Holewinski S, Hayes R, McComsey D, Umpierrez GE, et al. Glucose control, diabetes status, and mortality in critically ill patients: the continuum from intensive care unit admission to hospital discharge. Mayo Clin Proc. 2017;92(7):1019–29.
De La Rosa GD, Donado JH, Restrepo AH, Quintero AM, Gonzalez LG, Saldarriaga NE, et al. Strict glycemic control in patients hospitalized in a mixed medical and surgical intensive care unit: a randomized clinical trial. Crit Care. 2008;12(5): R120.
Goldberg PA, Siegel MD, Sherwin RS, Halickman JI, Lee M, Bailey VA, et al. Implementation of a Safe and Effective Insulin Infusion Protocol in a Medical Intensive Care Unit. Diabetes Care.004;27(2):461–7.
De Block CEM, Rogiers P, Jorens PG, Schepens T, Scuffi C, Van Gaal LF. A comparison of two insulin infusion protocols in the medical intensive care unit by continuous glucose monitoring. Ann Intensive Care. 2016;6(1):115.
Finfer S, Bellomo R, Blair D, Su SYS, Foster D, Dhingra V, et al. Intensive versus conventional glucose control in critically ill patients. N Engl J Med. 2009;360(13):1283–97.
American Diabetes Association. Primary Care - Standards of Medical Care in Diabetes. Diabetes Care. 2020;43(Suppl. 1):S1– 212.
Kumar S, Molitch ME. Use of Insulin in the Inpatient Setting: Need for Continued Use. Curr Diab Rep. 2019;19(9):64.
Lansang MC, Umpierrez GE. Inpatient hyperglycemia management: A practical review for primary medical and surgical teams. Cleve Clin J Med. 2016;83 (5 Suppl.):S34–43.
Moghissi ES, Korytkowski MT, DiNardo M, Einhorn D, Hellman R, Hirsch IB, et al. American Association of Clinical Endocrinologists and American Diabetes Association Consensus Statement on Inpatient Glycemic Control. Diabetes Care. 2009;32(6):1119–1131.
Umpierrez GE, Isaacs SD, Bazargan N, You X, Thaler LM, Kitabchi AE. Hyperglycemia: An independent marker of inhospital mortality in patients with undiagnosediabetes. J Clin Endocrinol Metab. 2002;87(3):978–982.
Cook CB, Kongable GL, Potter DJ, Abad VJ, Leija DE, Anderson M. Inpatient glucose control: a glycemic survey of 126 U.S. hospitals. J Hosp Med. 2009;4(9):E7–14.
Figueroa CL, Suárez FC, Ochoa AF, Rengifo LJ, Isaza JR. Hemoglobina glicosilada y eventos cardiovasculares en pacientes diabéticos de un hospital universitario. Acta Med Colomb. 2018; 43(2): 74–80.
Silva-Perez LJ, Benitez-Lopez MA, Varon J, Surani S. Management of critically ill patients with diabetes. World J Diabetes. 2017;8(3):89-96.
Falciglia M, Freyberg RW, Almenoff PL, D’Alessio DA, Render ML. Hyperglycemia-related mortality in critically ill patients varies with admission diagnosis. Crit Care Med. 2009;37(12):3001–9.
Krinsley JS. Association Between Hyperglycemia and Increased Hospital Mortality in a Heterogeneous Population of Critically Ill Patients. Mayo Clin Proc. 2003;78(12):1471–8.
Badawi O, Waite MD, Fuhrman SA, Zuckerman IH. Association between intensive care unit–acquired dysglycemia and inhospital mortality. Crit Care Med. 2012;40(12):3180–8.
Carpenter DL, Gregg SR, Xu K, Buchman TG, Coopersmith CM. Prevalence and Impact of Unknown Diabetes in the ICU. Crit Care Med. 2015;43(12):e541–550.
van Vught LA, Wiewel MA, Klein Klouwenberg PMC, Hoogendijk AJ, Scicluna BP, Ong DSY, et al. Admission Hyperglycemia in Critically Ill Sepsis Patients: Association With Outcome and Host Response. Crit Care Med. 2016;44(7):1338–1346.
Krikorian A, Ismail-Beigi F, Moghissi ES. Comparisons of different insulin infusion protocols: a review of recent literature. Curr Opin Clin Nutr Metab Care. 010;13(2):198–204.
Van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, et al. Intensive Insulin Therapy in Critically Ill Patients. N Engl J Med. 001;345(19):1359–1367.
Gill G V., Woodward A, Casson IF, Weston PJ. Cardiac arrhythmia and nocturnal hypoglycaemia in type 1 diabetes--the “dead in bed” syndrome revisited. Diabetologia. 009;52(1):42–5.
Krinsley JS. Effect of an Intensive Glucose Management Protocol n the Mortality of Critically Ill Adult Patients. Mayo Clin Proc. 2004;79(8):992–1000.
Preiser J-C, Devos P, Ruiz-Santana S, Mélot C, Annane D, Groeneveld J, et al. A prospective randomised multi-centre controlled trial on tight glucose control by ntensive insulin therapy in adult intensive care units: the Glucontrol study. Intensive Care Med. 2009;35(10):1738–1748.
Krinsley JS, Grover A. Severe hypoglycemia in critically ill patients: risk factors and outcomes. Crit Care Med. 2007;35(10):2262–7.
Griesdale DEG, de Souza RJ, van Dam RM, Heyland DK, Cook DJ, Malhotra A, et al. Intensive insulin therapy and mortality among critically ill patients: a meta-analysis including NICE-SUGAR study data. CMAJ. 2009;180(8):821-7.
Van den Berghe G, Wilmer A, Hermans G, Meersseman W, Wouters PJ, Milants I, et al. Intensive Insulin Therapy in the Medical ICU. N Engl J Med. 2006;354(5):449–61.
Chase JG, Pretty CG, Pfeifer L, Shaw GM, Preiser JC, Le Compte AJ, et al. Organ failure and tight glycemic control in the SPRINT study. Crit Care. 2010;14(4): R154.
Brunkhorst FM, Engel C, Bloos F, Meier-Hellmann A, Ragaller M, Weiler N, et al. Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med. 2008;358(2):125–39.
Finfer S, Bellomo R, Blair D, Su SYS, Foster D, Dhingra V, et al. Intensive versus conventional glucose control in critically Ill patients. N Engl J Med. 2009;360(13):1283–97.
Wiener RS, Wiener DC, Larson RJ. Benefits and risks of tight glucose control in critically ill adults: a meta-analysis. JAMA. 2008;300(8):933-44.
Umpierrez G, Cardona S, Pasquel F, Jacobs S, Peng L, Unigwe M, et al. Randomized controlled trial of intensive versus conservative glucose control in patients undergoing coronary artery bypass graft surgery: GLUCOCABG trial. Diabetes Care. 2015;38(9):1665–72.
Egi M, Bellomo R, Stachowski E, French CJ, Hart GK, Taori G, et al. The interaction of chronic and acute glycemia with mortality in critically ill patients with diabetes. Crit Care Med. 2011;39(1):105–11.
Krinsley JS, Egi M, Kiss A, Devendra AN, Schuetz P, Maurer PM, et al. Diabetic status and the relation of the three domains of glycemic control to mortality in critically ill patients: An international multicenter cohort study. Crit Care. 2013;17(2): R37.
Marik PE, Egi M. Treatment thresholds for hyperglycemia in critically ill patients with and without diabetes. Intensive Care Med. 2014; 40(7): 1049–51.
Krinsley JS, Maurer P, Holewinski S, Hayes R, McComsey D, Umpierrez GE, et al. Glucose control, diabetes status, and mortality in critically ill patients: the continuum from intensive care unit admission to hospital discharge. Mayo Clin Proc. 2017;92(7):1019–29.
De La Rosa GD, Donado JH, Restrepo AH, Quintero AM, Gonzalez LG, Saldarriaga NE, et al. Strict glycemic control in patients hospitalized in a mixed medical and surgical intensive care unit: a randomized clinical trial. Crit Care. 2008;12(5): R120.
Goldberg PA, Siegel MD, Sherwin RS, Halickman JI, Lee M, Bailey VA, et al. Implementation of a Safe and Effective Insulin Infusion Protocol in a Medical Intensive Care Unit. Diabetes Care.004;27(2):461–7.
De Block CEM, Rogiers P, Jorens PG, Schepens T, Scuffi C, Van Gaal LF. A comparison of two insulin infusion protocols in the medical intensive care unit by continuous glucose monitoring. Ann Intensive Care. 2016;6(1):115.
Finfer S, Bellomo R, Blair D, Su SYS, Foster D, Dhingra V, et al. Intensive versus conventional glucose control in critically ill patients. N Engl J Med. 2009;360(13):1283–97.
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
Derechos de autor 2020 Médicas UIS
Descargas
Los datos de descargas todavía no están disponibles.