Stress-hyperglycemia, Insulin and Immunomodulation in Sepsis

Overview

Journal Intensive Care Med

Specialty Critical Care

Date 2004 Mar 3

PMID 14991101

Citations 132

Authors

Paul E Marik

Murugan Raghavan

Affiliations

Soon will be listed here.

Abstract

Stress-hyperglycemia and insulin resistance are exceedingly common in critically ill patients, particularly those with sepsis. Multiple pathogenetic mechanisms are responsible for this metabolic syndrome; however, increased release of pro-inflammatory mediators and counter-regulatory hormones may play a pivotal role. Recent data suggests that hyperglycemia may potentiate the pro-inflammatory response while insulin has the opposite effect. Furthermore, emerging evidence suggests that tight glycemic control will improve the outcome of critically ill patients. This paper reviews the pathophysiology of stress hyperglycemia in the critically ill septic patient and outlines a treatment strategy for the management of this disorder.

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