Hiperglicemia por sepsis: del mecanismo a la clínica
Autor
Resumen/Reseña
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.
Indización
Artículo de publicación ISI
Identificador
URI: https://repositorio.uchile.cl/handle/2250/152866
DOI: 10.4067/s0034-98872018000400502
ISSN: 0034-9887
Cita del ítem
Rev Med chile 2018; 146: 502-510
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