Relationship Between Hyperglycemia and Infection in Critically Ill Patients

  title={Relationship Between Hyperglycemia and Infection in Critically Ill Patients},
  author={Simona O. Butler and Imad F. Btaiche and Cesar Alaniz},
  journal={Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy},
Hyperglycemia is a common problem encountered in hospitalized patients, especially in critically ill patients and those with diabetes mellitus. Uncontrolled hyperglycemia may be associated with complications such as fluid and electrolyte disturbances and increased infection risk. Studies have demonstrated impairment of host defenses, including decreased polymorphonuclear leukocyte mobilization, chemotaxis, and phagocytic activity related to hyperglycemia. Until 2001, hyperglycemia (blood… 

Mechanisms underlying stress-induced hyperglycemia in critically ill patients

An overview of the current insights in hyperglycemia and insulin resistance in critical illnesses is given and strict glycemic control and intensive insulin therapy could improve the survival rate in critically ill patients.

Perioperative glucose control.

  • J. Krinsley
  • Medicine
    Current opinion in anaesthesiology
  • 2006
Additional studies are needed in heterogeneous populations of critically ill patients as well as in other populations of acutely ill patients, especially general surgical patients, to confirm the early studies and define the correct glycemic target.

Hyperglycemia is associated with poor outcomes in surgical critically ill patients receiving parenteral nutrition.

Using Insulin Glargine Temporarily to Control Resistant Hyperglycemia Induced by Mild to Moderate Bacterial Infections in Egyptian Type 2 Diabetic Out Patients: A Real Life Experience

It’s logic to notice that infectious diseases are more frequent and/or serious in patients suffering from diabetes mellitus leading to a significant increase in their morbimortality.

Alterations of blood glucose homeostasis in critically ill children - hyperglycemia.

A prospective, randomized trial of strict glycemic control in this subset of critically ill children who are at high risk of mortality is both warranted and feasible.

Impact of hyperglycemia on outcomes of patients with Pseudomonas aeruginosa bacteremia.

Hyperactive Delirium and Blood Glucose Control in Critically Ill Patients

Higher overall complication rates, length of ventilation, ICU stay and mortality rates were seen in the delirium group, and in a multivariate analysis, glucose level, alcohol abuse, APACHE II score, complication by hospital-acquired pneumonia and a diagnosis of polytrauma on-admission all significantly influenced the appearance ofDelirium.

The Effect of Short‐Term Hyperglycemia on the Innate Immune System

Prevalence and Management of Stress Hyperglycemia in Critical Care Unit

Compared with other studies, lower prevalence of hyperglycemia in ICU was seen in current study, so, blood glucose monitoring (every 6 h) was associated with better outcomes and according to the AACE/ADA guidelines, insulin infusion method is preferred for management of hyper glycemia.

The association between blood glucose levels and hospital outcomes in patients admitted with acute exacerbations of chronic obstructive pulmonary disease

Patients with acute exacerbations of chronic obstructive pulmonary disease should have bedside point of care glucose measurements during the early course of their hospitalizations, because hyperglycemia represents an independent risk factor for hospital associated complications and/or mortality in other medical diagnoses.



Glucose control and mortality in critically ill patients.

Control of glucose levels rather than of absolute levels of exogenous insulin appear to account for the mortality benefit associated with intensive insulin therapy demonstrated by others.

Hyperglycemia in acutely ill patients.

The evidence supporting the hyperglycemic milieu as a risk factor for adverse outcomes in the acutely ill patient with and without known diabetes is discussed, and the efficacy and safety of implementing tighter glycemic control for hospitalized patients are discussed.

Metabolic, endocrine, and immune effects of stress hyperglycemia in a rabbit model of prolonged critical illness.

Investigation of the effect of blood glucose control with insulin on endocrine, metabolic, and immune function in an animal model of severe injury found maintenance of normoglycemia with exogenous insulin after severe trauma to a large extent prevented weight loss, lactic acidosis, and hyponatremia.

Stress-induced hyperglycemia.

Association between hyperglycemia and increased hospital mortality in a heterogeneous population of critically ill patients.

Even a modest degree of hyperglycemia occurring after intensive care unit admission was associated with a substantial increase in hospital mortality in patients with a wide range of medical and surgical diagnoses, adding predictive power above that achieved by APACHE II scores alone.

Beyond diabetes: saving lives with insulin in the ICU

  • G. Berghe
  • Medicine, Biology
    International Journal of Obesity
  • 2002
Regression analysis suggests that control of glucose levels, rather than insulin administration itself, was responsible for the clinical benefits observed, and use of insulin infusion to control glucose levels in ICU patients can be expected to achieve clinically welcome improvements in outcome.

Intensive insulin therapy exerts antiinflammatory effects in critically ill patients and counteracts the adverse effect of low mannose-binding lectin levels.

Intensive insulin therapy exerts a powerful antiinflammatory effect during critical illness which at least partially explains improvement in morbidity and mortality.

Management of glucose abnormalities in patients receiving total parenteral nutrition.

Clinicians should be aware of the risk of hyperglycemia and hypoglycemia in patients receiving TPN and monitor patients appropriately for alterations in glucose homeostasis.