Hiperglicemia por sepsis: del mecanismo a la clínica / Sepsis hyperglycemia in the ICU: from the mechanism to the clinic
Rev. méd. Chile
;
146(4): 502-510, abr. 2018. tab, graf
Artigo
em Espanhol
| LILACS
| ID: biblio-961421
ABSTRACT
Stress hyperglycemia is frequently diagnosed in septic patients in critical care units (ICU) and it is associated with greater illness severity and higher morbimortality rates. In response to an acute injury, high levels of counterregulatory hormones such as glucocorticoids and catecholamines are released causing increased hepatic gluconeogenesis and insulin resistance. Furthermore, during sepsis, proinflammatory cytokines also participate in the pathogenesis of this phenomenon. Septic patients represent a subtype of the critical ill patients in the ICU: this metabolic disarrangement management strategies and insulin therapy recommendations had been inconsistent. In this article, we describe the pathophysiological mechanisms of stress hyperglycemia in critical patients including the action of hormones, inflammatory cytokines and tissue resistance to insulin. In addition, we analyzed the main published studies for the treatment of acute hyperglycemia in critical patients.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Sepse
/
Hiperglicemia
Tipo de estudo:
Guia de Prática Clínica
Limite:
Humanos
Idioma:
Espanhol
Revista:
Rev. méd. Chile
Assunto da revista:
Medicina
Ano de publicação:
2018
Tipo de documento:
Artigo
País de afiliação:
Chile
Instituição/País de afiliação:
Universidad de Chile/CL
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