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Intensivmedizin up2date 2017; 13(01): 51-61
DOI: 10.1055/s-0043-101038
Internistische Intensivmedizin
© Georg Thieme Verlag KG Stuttgart · New York

Steuerung des Blutzuckers – Ist ideal gleich optimal?

Antje Gottschalk
,
Hannah Listing
,
Laura Leser
,
Björn Ellger
Further Information

Publication History

Publication Date:
23 February 2017 (online)

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Starke Schwankungen des Blutzuckerspiegels sowie insbesondere Hypoglykämien beeinflussen in erheblichem Ausmaß Verlauf und Outcome von Intensivpatienten. Doch auch bei einer liberalen Blutzuckerführung sind Hypoglykämien nicht immer sicher zu vermeiden. Geeignete Messverfahren und Therapiealgorithmen können dazu beitragen, solche Probleme zu entschärfen.
Kernaussagen

  • Die zum Teil kontroversen Studienresultate zur BZ-Kontrolle auf der Intensivstation erlauben kein einfaches Kochrezept und keine simplen evidenzbasierten Empfehlungen.

  • Klar ist, dass schwere Hypo- und Hyperglykämien sowie Schwankungen des BZ vermieden werden müssen.

  • Bis geeignete kontinuierliche Messmethoden verfügbar sind, ist eine mit Fingerspitzengefühl durchgeführte, an den Einzelfall angepasste, liberale Einstellung des BZ ein praktikabler und sinnvoller Weg.

  • Individuell zur jeweiligen Abteilung passende Algorithmen sollte man im Team erarbeiten, schulen und umsetzen.

  • Neue Verfahren der BZ-Messung und prädiktive Algorithmen könnten die BZ-Kontrolle in der täglichen Praxis vereinfachen und zu einer positiven Prognose der Patienten beitragen.

 

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