[Metabolic control in the critically ill patient an update: hyperglycemia, glucose variability hypoglycemia and relative hypoglycemia]. / Actualidades en el control metabólico del paciente crítico: hiperglucemia, variabilidad de la glucosa, hipoglucemia e hipoglucemia relativa.

BACKGROUND: Metabolic changes of glucose in critically ill patients increase morbidity and mortality. The appropriate level of blood glucose has not been established so far and should be adjusted for different populations. However concepts such as glucose variability and relative hypoglycemia of critically ill patients are concepts that are changing management methods and achieving closer monitoring. OBJECTIVES: The purpose of this review is to present new data about the management and metabolic control of patients in critical areas. CONCLUSIONS: Currently glucose can no longer be regarded as an innocent element in critical patients; both hyperglycemia and hypoglycemia increase morbidity and mortality of patients. Protocols and better instruments for continuous measurement are necessary to achieve the metabolic control of our patients.