Pitrowsky Melissa, Shinotsuka Cassia Righy, Soares Márcio, Salluh Jorge Ibrain Figueira
Instituto Nacional de Câncer, Rio de Janeiro, RJ, Brasil.
Rev Bras Ter Intensiva. 2009 Aug;21(3):310-4.
Glucose control is a major issue in critical care since landmark publications from the last decade leading to widespread use of strict glucose control in the clinical practice. Subsequent trials showed discordant results that lead to several questions and concerns about benefits and risks of implementing an intensive glucose control protocol. In the midst of all recent controversy, we propose that a new glycemic target -150mg/dl) should be aimed. This target glucose level could offer protection against the deleterious effects of hyperglycemia and at the same time keep patient's safety avoiding hypoglicemia. The article presents a critical review of the current literature on intensive insulin therapy in critically ill patients.
血糖控制是重症监护中的一个主要问题，自上世纪末具有里程碑意义的出版物问世以来，严格血糖控制在临床实践中得到了广泛应用。随后的试验结果不一致，引发了人们对实施强化血糖控制方案的益处和风险的诸多疑问和担忧。在最近所有的争议中，我们建议设定一个新的血糖目标（150mg/dl）。这个目标血糖水平可以防止高血糖的有害影响，同时保证患者安全，避免低血糖。本文对当前有关重症患者强化胰岛素治疗的文献进行了批判性综述。
