Glucose control in the ICU.

Current Opinion in Anaesthesiology
Jan GunstGreet Van den Berghe

Abstract

Critically ill patients usually develop hyperglycemia, which is associated with adverse outcome. Controversy exists whether the relationship is causal or not. This review summarizes recent evidence regarding glucose control in the ICU. Despite promising effects of tight glucose control in pioneer randomized controlled trials, the benefit has not been confirmed in subsequent multicenter studies and one trial found potential harm. This discrepancy could be explained by methodological differences between the trials rather than by a different case mix. Strategies to improve the efficacy and safety of tight glucose control have been developed, including the use of computerized treatment algorithms. The ideal blood glucose target remains unclear and may depend on the context. As compared with tolerating severe hyperglycemia, tight glucose control is well tolerated and effective in patients receiving early parenteral nutrition when provided with a protocol that includes frequent, accurate glucose measurements and avoids large glucose fluctuations. All patient subgroups potentially benefit, with the possible exception of patients with poorly controlled diabetes, who may need less aggressive glucose control. It remains unclear whether t...Continue Reading

References

Jan 17, 2002·The New England Journal of Medicine·G van den BergheR Bouillon
Feb 11, 2003·Critical Care Medicine·Greet Van den BerghePeter Lauwers
Feb 3, 2006·The New England Journal of Medicine·Greet Van den BergheRoger Bouillon
Mar 8, 2006·Critical Care Medicine·Greet Van den BergheDaniel E Hilleman
Sep 1, 2006·Critical Care Medicine·Titia M VriesendorpJoost B L Hoekstra
Apr 4, 2007·The Journal of Clinical Investigation·Sang Won SuhRaymond A Swanson
Jan 11, 2008·The New England Journal of Medicine·Frank M BrunkhorstUNKNOWN German Competence Network Sepsis (SepNet)
Dec 6, 2008·Critical Care : the Official Journal of the Critical Care Forum·Patrick LecomteLuc Foubert
Feb 25, 2009·Anesthesiology·Federico BilottaGiovanni Rosa
Mar 26, 2009·The New England Journal of Medicine·Simon FinferJuan J Ronco
Jun 19, 2009·Kidney International·Ilse VanhorebeekGreet Van den Berghe
Aug 8, 2009·Critical Care Medicine·Mercedes FalcigliaMarta L Render
Jan 28, 2010·JAMA : the Journal of the American Medical Association·Djillali AnnaneSylvie Chevret
Apr 17, 2010·American Journal of Respiratory and Critical Care Medicine·Marc G JeschkeDavid N Herndon
Jun 9, 2010·Seminars in Dialysis·Jan Gunst, Greet Van den Berghe
Jul 30, 2010·The Journal of Clinical Endocrinology and Metabolism·Ilse VanhorebeekGreet Van den Berghe
Sep 16, 2010·Critical Care : the Official Journal of the Critical Care Forum·Carole IchaiUNKNOWN Experts group
Jul 1, 2011·The New England Journal of Medicine·Michael P CasaerGreet Van den Berghe
Sep 11, 2012·The New England Journal of Medicine·Michael S D AgusUNKNOWN SPECS Study Investigators
Sep 21, 2012·The New England Journal of Medicine·Simon FinferBruce G Robinson
Oct 27, 2012·JAMA : the Journal of the American Medical Association·Dieter MesottenGreet Van den Berghe
Mar 5, 2013·Critical Care : the Official Journal of the Critical Care Forum·James S KrinsleyRinaldo Bellomo
Jun 19, 2013·Critical Care : the Official Journal of the Critical Care Forum·Simon FinferTom Van Herpe
Jul 26, 2013·Critical Care : the Official Journal of the Critical Care Forum·Lalantha LeelarathnaRoman Hovorka
Jan 10, 2014·The New England Journal of Medicine·Duncan MacraeUNKNOWN CHiP Investigators
Jan 15, 2014·Intensive Care Medicine·Pierre KalfonUNKNOWN CGAO-REA Study Group
Mar 14, 2014·Diabetes Care·Takehiro OkabayashiKazuhiro Hanazaki
Jun 20, 2015·Intensive Care Medicine·UNKNOWN NICE-SUGAR Study Investigators for the Australian and New Zealand Intensive Care Society Clinical Trials Group and the CanadJuan Ronco
Feb 6, 2016·Intensive Care Medicine·Moritoki EgiRinaldo Bellomo
Mar 16, 2016·The New England Journal of Medicine·Tom FivezGreet Van den Berghe
Mar 31, 2016·Annals of Intensive Care·Kent W StewartJ Geoffrey Chase
May 11, 2016·Intensive Care Medicine·Jean-Charles Preiser, Heleen M Oudemans-van Straaten
May 11, 2016·Intensive Care Medicine·Jan Gunst, Greet Van den Berghe
Nov 3, 2016·Journal of Diabetes Science and Technology·Jean-Charles PreiserJan Wernerman
Jan 25, 2017·The New England Journal of Medicine·Michael S D AgusUNKNOWN HALF-PINT Study Investigators and the PALISI Network
Jun 8, 2017·The New England Journal of Medicine·Michael S D AgusVinay M Nadkarni,
Jun 9, 2017·The New England Journal of Medicine·Jan Gunst, Greet Van den Berghe

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Citations

Feb 7, 2020·Nutrients·Elisabeth De WaeleHerbert Spapen
Jul 25, 2020·International Journal of Nursing Knowledge·Lídia Miranda BrinatiPatrícia de Oliveira Salgado
Apr 18, 2020·BioEssays : News and Reviews in Molecular, Cellular and Developmental Biology·Julie Bienertova-VaskuMartin Scheringer
May 30, 2019·Diabetes/metabolism Research and Reviews·Omar G Mustafa, Martin B Whyte
Mar 17, 2020·EMBO Molecular Medicine·Jean-Marc CavaillonTomasz Skirecki
Aug 26, 2020·Journal of Intensive Care Medicine·Maximilian HammerMatthias Eikermann
Nov 4, 2020·Der Anaesthesist·B RupprechtC Dietrich
Dec 29, 2020·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·Michael P CasaerJan Gunst
Jan 31, 2021·The Lancet. Diabetes & Endocrinology·Francisco J PasquelGuillermo E Umpierrez
Nov 14, 2020·Anesthesia and Analgesia·Khaschayar Saadat-GilaniMelanie Meersch
Apr 5, 2021·Diabetes Research and Clinical Practice·Chiara LazzeriAdriano Peris
Aug 10, 2021·Frontiers in Pediatrics·Kathryn Beardsall
Jun 7, 2021·Deutsches Ärzteblatt International·Johannes RothChristian von Loeffelholz
Nov 11, 2020·Medicina intensiva·Raimundo García Del Moral-MartínManuel Colmenero
Dec 19, 2021·Critical Care : the Official Journal of the Critical Care Forum·Lies LangoucheJan Gunst

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