Glucose control after severe brain injury.

Détails

ID Serval
serval:BIB_40BCEFC300F3
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
Glucose control after severe brain injury.
Périodique
Current Opinion in Clinical Nutrition and Metabolic Care
Auteur(s)
Oddo M., Schmidt J.M., Mayer S.A., Chioléro R.L.
ISSN
1363-1950
Statut éditorial
Publié
Date de publication
2008
Peer-reviewed
Oui
Volume
11
Numéro
2
Pages
134-139
Langue
anglais
Notes
Publication types: Journal Article ; Review -
Résumé
PURPOSE OF REVIEW: A substantial body of evidence supports the use of intensive insulin therapy in general critical care practice, particularly in surgical intensive care unit patients. The impact of intensive insulin therapy on the outcome of critically ill neurological patients, however, is still controversial. While avoidance of hyperglycemia is recommended in neurointensive care, no recommendations exist regarding the optimal target for systemic glucose control after severe brain injury. RECENT FINDINGS: An increase in brain metabolic demand leading to a deficiency in cerebral extracellular glucose has been observed in critically ill neurological patients and correlates with poor outcome. In this setting, a reduction of systemic glucose below 6 mmol/l with exogenous insulin has been found to exacerbate brain metabolic distress. Recent studies have confirmed these findings while showing intensive insulin therapy to have no substantial benefit on the outcome of critically ill neurological patients. SUMMARY: Questions persist regarding the optimal target for glucose control after severe brain injury. Further studies are needed to analyze the impact of intensive insulin therapy on brain glucose metabolism and outcome of critically ill neurological patients. According to the available evidence, a less restrictive target for systemic glucose control (6-10 mmol/l) may be more appropriate.
Mots-clé
Blood Glucose/metabolism, Brain Injuries/metabolism, Critical Care/methods, Critical Illness, Humans, Hypoglycemic Agents/therapeutic use, Insulin/therapeutic use, Prognosis, Treatment Outcome
Pubmed
Web of science
Création de la notice
13/10/2009 12:03
Dernière modification de la notice
03/03/2018 16:29
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