Stress hyperglycemia, defined as a transient plasma glucose level above 200 mg/dL,
is associated with adverse outcomes among the critically ill, including increased
mortality [
1
,
2
,
3
,
- Malmberg K.
- Norhammar A.
- Wedel H.
- et al.
Glycometabolic state at admission: important risk marker of mortality in conventionally
treated patients with diabetes mellitus and acute myocardial infarction: long-term
results from the diabetes and insulin-glucose infusion in acute myocardial infarction
(DIGAMI) study.
Circulation. 1999; 99: 2626-2632
4
,
5
,
6
,
7
]. Since the landmark study conducted by Van den Berghe and colleagues [
[8]
] in Leuven, Belgium, first demonstrated improved survival in ICU patients treated
with intensive insulin therapy, there has been considerable attention dedicated toward
defining the ideal therapy required to optimize outcome for critically ill patients
with hyperglycemia. Although subsequent studies have failed to replicate the findings
of the Leuven group, these investigations lacked the methodologic rigor of the initial
studies and have provided few data that can be effectively extrapolated to the care
of ICU populations, including victims of trauma. The largest body of work examining
the risks and treatment of hyperglycemia after injury has been conducted at the University
of Maryland R Adams Cowley Shock Trauma Center [
1
,
8
,
9
,
10
,
11
]. Data from the authors’ group have demonstrated that hyperglycemia has a significant
association with adverse outcomes after trauma and that intervention with insulin
therapy may significantly improve outcomes for these patients.To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 04, 2011
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© 2011 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
