Copyright
©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Surg Proced. Nov 28, 2016; 6(3): 30-39
Published online Nov 28, 2016. doi: 10.5412/wjsp.v6.i3.30
Published online Nov 28, 2016. doi: 10.5412/wjsp.v6.i3.30
Glycemic management in critically ill patients
Eden A Nohra, Jarot J Guerra, Grant V Bochicchio, Section of Acute and Critical Care Surgery, Department of Surgery, Washington University in St. Louis, St. Louis, MO 63110, United States
Author contributions: Nohra EA and Guerra JJ conducted the literature search and wrote the paper; Guerra JJ designed the figure; Bochicchio GV provided mentorship and edited the manuscript.
Conflict-of-interest statement: Authors declare no conflict of interest for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Eden A Nohra, MD, Section of Acute and Critical Care Surgery, Department of Surgery, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States. nohrae@wudosis.wustl.edu
Telephone: +1-314-4439727 Fax: +1-314-3625743
Received: May 27, 2016
Peer-review started: May 30, 2016
First decision: June 30, 2016
Revised: August 6, 2016
Accepted: August 27, 2016
Article in press: August 29, 2015
Published online: November 28, 2016
Peer-review started: May 30, 2016
First decision: June 30, 2016
Revised: August 6, 2016
Accepted: August 27, 2016
Article in press: August 29, 2015
Published online: November 28, 2016
Core Tip
Core tip: Hyperglycemia is not innocuous, especially in the critically ill; and glucose control has been shown to significantly impact morbidity and mortality. In this review, we describe the pathophysiology of the “diabetes of stress”; we summarize the major investigations that constitute the body of evidence and the reasons behind current practices. Further, we emphasize glucose considerations in special populations, especially trauma and postoperative populations. Finally, we provide insight on the relative importance of avoiding hyperglycemia, hypoglycemia, and glucose variability.