Hiperglicemia por sepsis: del mecanismo a la clínica
Author
dc.contributor.author
Aleman, Larissa
Author
dc.contributor.author
Guerrero, Julia
Admission date
dc.date.accessioned
2018-11-26T13:17:27Z
Available date
dc.date.available
2018-11-26T13:17:27Z
Publication date
dc.date.issued
2018-04
Cita de ítem
dc.identifier.citation
Rev Med chile 2018; 146: 502-510
es_ES
Identifier
dc.identifier.issn
0034-9887
Identifier
dc.identifier.other
10.4067/s0034-98872018000400502
Identifier
dc.identifier.uri
https://repositorio.uchile.cl/handle/2250/152866
Abstract
dc.description.abstract
Stress hyperglycemia is frequently diagnosed in septic patients in critical care units (ICU) and it is associated with greater illness severity and higher morbimortality rates. In response to an acute injury, high levels of counterregulatory hormones such as glucocorticoids and catecholamines are released causing increased hepatic gluconeogenesis and insulin resistance. Furthermore, during sepsis, proinflammatory cytokines also participate in the pathogenesis of this phenomenon. Septic patients represent a subtype of the critical ill patients in the ICU: this metabolic disarrangement management strategies and insulin therapy recommendations had been inconsistent. In this article, we describe the pathophysiological mechanisms of stress hyperglycemia in critical patients including the action of hormones, inflammatory cytokines and tissue resistance to insulin. In addition, we analyzed the main published studies for the treatment of acute hyperglycemia in critical patients.