Hyperglycaemia in criticaly ill patients

Abstract

The review highlights the problem of stress-induced hyperglycaemia (IT). The study of this condition is in demand because there is an association between IT and increasing number of complications and mortality among patients in critical state. In the review pathological and physiological mechanisms of stress-induced IT syndrome and its components are shown. These are acute IT, insulin resistance and hyperinsulinemia. The range of critical states, in which development of stress-induced IT is more probable and the IT negative impact on different organs and systems are described in the article. Clinical significance, influence on treatment and complications development of stress-induced IT are considered. It has been shown that adequate control and correction of IT are leading to improvement in critically ill patients state. Much attention in the review is paid to early diagnostics of any carbohydrate abnormalities in critical care medicine, as well as to prevention and optimal correction of IT. The variety of IT correction methods, target glucose levels and various therapeutic methods of hyperglycaemia correction are discussed. Dealing with hyperglycaemia in intensive care units is described in details.

Keywords

• hyperglycemia
• critical illness
• stress
• insulin