©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Surg Proced. Nov 28, 2016; 6(3): 30-39
Published online Nov 28, 2016. doi: 10.5412/wjsp.v6.i3.30
Published online Nov 28, 2016. doi: 10.5412/wjsp.v6.i3.30
Glycemic management in critically ill patients
Eden A Nohra, Jarot J Guerra, Grant V Bochicchio, Section of Acute and Critical Care Surgery, Department of Surgery, Washington University in St. Louis, St. Louis, MO 63110, United States
Author contributions: Nohra EA and Guerra JJ conducted the literature search and wrote the paper; Guerra JJ designed the figure; Bochicchio GV provided mentorship and edited the manuscript.
Conflict-of-interest statement: Authors declare no conflict of interest for this article.
Correspondence to: Eden A Nohra, MD, Section of Acute and Critical Care Surgery, Department of Surgery, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States. nohrae@wudosis.wustl.edu
Telephone: +1-314-4439727 Fax: +1-314-3625743
Received: May 27, 2016
Peer-review started: May 30, 2016
First decision: June 30, 2016
Revised: August 6, 2016
Accepted: August 27, 2016
Article in press: August 29, 2015
Published online: November 28, 2016
Processing time: 180 Days and 16.9 Hours
Peer-review started: May 30, 2016
First decision: June 30, 2016
Revised: August 6, 2016
Accepted: August 27, 2016
Article in press: August 29, 2015
Published online: November 28, 2016
Processing time: 180 Days and 16.9 Hours
Core Tip
Core tip: Hyperglycemia is not innocuous, especially in the critically ill; and glucose control has been shown to significantly impact morbidity and mortality. In this review, we describe the pathophysiology of the “diabetes of stress”; we summarize the major investigations that constitute the body of evidence and the reasons behind current practices. Further, we emphasize glucose considerations in special populations, especially trauma and postoperative populations. Finally, we provide insight on the relative importance of avoiding hyperglycemia, hypoglycemia, and glucose variability.