Keywords
Glucose
Critical Care
Insulin
Infusions
Parenteral
Clinical Protocols
Critical Care
Insulin
Infusions
Parenteral
Clinical Protocols
How to Cite
Arias-Amaya, A. M., Castellanos-Bueno, R., Rangel-Rivera, D. A., & Pinto-Arias, A. J. (2020). Clinical aspects of the treatment of uncomplicated hyperglycemia in the intensive care unit. Médicas UIS, 33(2), 49–54. https://doi.org/10.18273/revmed.v33n2-2020006
Abstract
Introduction: glucose is a dynamic variable in the critically ill patient. Hyperglycemia (greater than 140 mg/dL) is frequent in this group of patients, and there are different therapeutic treatments for its adequate control. Objectives: to evaluate the clinical aspects of glycemia and the importance of glycemic control in the critically ill adult patient. Methodology: search in Pubmed database using the MeSH terms: “critical illness”, “insulin infusion”, “insulin protocol”, hyperglycemia”. Original and review articles are included, in English and Spanish. onclusions: the management of hyperglycemia in the critically ill patient is a primary objective in the comprehensive approach of the patient in the intensive care unit due to its association with mortality, morbidity and hospital stay.MÉD.UIS.2020;33(2): 49-54.
References
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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.
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