Blutzuckereinstellung auf Intensivstation – intensiviert oder konservativ?

Abstract

Tight blood glucose control in critical ill patients has been discussed controversially during the last years. Several studies have recently demonstrated a reduction of morbidity and mortality in critical ill patients treated with tight glycemic control, while others could not confirm theses findings. In addition, various studies targeting elevated glucose levels by insulin therapy in patients with acute coronary syndrome showed only mixed results. Moreover, recent data suggest that hypoglycemia is associated with an increased mortality rate in patients with ACS and several studies have shown that hypoglycemia is an independent risk factor for overall mortality in patients with severe sepsis and septic shock. The present article reviews current data on tight glucose control in critical ill patients and analyzes their significance for clinical practice.

Kernaussage

Aufgrund der vorliegenden Datenlage erscheint bei Patienten mit ACS und erwachsenen, kritisch kranken Patienten eine konventionelle Blutzuckereinstellung (Zielbereich 144 – 180 mg/dl bzw. 8,0 – 10,0 mmol/l) unter Vermeidung von Hypoglykämien gerechtfertigt.

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