Hyperglycaemia and neurological injury.
Curr Opin Anaesthesiol
; 21(5): 565-9, 2008 Oct.
Article
em En
| MEDLINE
| ID: mdl-18784480
ABSTRACT
PURPOSE OF REVIEW Clinical and experimental data suggest that hypergylcaemia lowers the ischaemic neuronal threshold and worsens outcome in the presence of neurological injury from trauma, stroke and subarachnoid haemorrhage. This review aims to appraise the evidence for tight glycaemic control in patients with neurological injury. RECENT FINDINGS:
Hyperglycaemia can adversely affect outcome in critically ill patients. Intensive insulin therapy with tight glycaemic control has been advocated for improving outcome in these patients. However, the extent to which intensive insulin therapy and tight control of blood glucose improve outcome after ischaemic neurological insults remains unclear. The benefit of such treatment regimes may be negated by the increased frequency of hypoglycaemic episodes, which may aggravate neurological injury. Although it seems sensible to control hyperglycaemia in patients with neurological injury, the treatment must account for potential hypoglycaemic episodes.SUMMARY:
Clinical and experimental data suggest that hyperglycaemia lowers the ischaemic neuronal threshold in the presence of neurological injury. Tight glycaemic control may result in hypoglycaemia, which in itself can be detrimental. Therefore, it seems sensible that we should accept slightly less tight blood glucose control than in the critically ill patient without neurological injury.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Estado Terminal
/
Hiperglicemia
/
Anestesia
/
Doenças do Sistema Nervoso
Tipo de estudo:
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
Curr Opin Anaesthesiol
Assunto da revista:
ANESTESIOLOGIA
Ano de publicação:
2008
Tipo de documento:
Article
País de afiliação:
Reino Unido