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Glycaemic control in critical illness 

Glycaemic control in critical illness
Chapter:
Glycaemic control in critical illness
Author(s):

Simon Finfer

DOI:
10.1093/med/9780199600830.003.0259
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date: 01 December 2020

Hyperglycaemia is a near universal occurrence in critically-ill patients. In the last 10 years, control of blood glucose has been one of the most intensively studied areas of critical care medicine. It has become clear that control of blood glucose has the potential to affect both morbidity and mortality, and considerable uncertainty remains over many aspects of blood glucose management. Both hyperglycaemia and hypoglycaemia are associated with increased mortality and should be avoided wherever possible. Wide fluctuations in blood glucose concentration (referred to as increased glucose variability) are also associated with increased mortality, but may indicate more severe illness. Increased interest in blood glucose management has demonstrated that point-of-care glucose meters designed for ambulatory use by patient with diabetes are not sufficiently accurate for use in critically-ill patients. More accurate analysers should be used in the intensive care unit and management guided by computerized. Future developments may see the introduction of accurate continuous or near continuous blood glucose analysers, but safe and effective closed loop control of blood glucose remains an elusive goal.

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