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Hyperglycaemia in critically ill patients: marker or mediator of mortality?

of Anaesthesiology, Intensive & Respiratory Care Unit, University Medical Center Groningen, Groningen, The Netherlands of Cardiology, University Medical Center Groningen, Groningen, The Netherlands 3Intensive & Respiratory Care Unit, University Medical Center Groningen, Groningen, The Netherlands 4Department of Intensive Care, Vrije Universiteit Medical Center, Amsterdam, The Netherlands Corresponding author: Jack JM Ligtenberg, j.j.m.ligtenberg@int.umcg.nl Published: 27 June 2006 This article is online at http://ccforum.com/content/10/3/216 © 2006 BioMed Central Ltd Critical Care 2006, 10:216 (doi:10.1186/cc4957) Abstract Acute hyperglycaemia has been associated with complications,. | Available online http ccforum.eom content 10 3 216 Review Hyperglycaemia in critically ill patients marker or mediator of mortality Anouk M Corstjens1 Iwan CC van der Horst2 Jan G Zijlstra3 AB Johan Groeneveld4 Felix Zijlstra2 Jaap E Tulleken3 and Jack JM Ligtenberg3 1 Department of Anaesthesiology Intensive Respiratory Care Unit University Medical Center Groningen Groningen The Netherlands 2Department of Cardiology University Medical Center Groningen Groningen The Netherlands intensive Respiratory Care Unit University Medical Center Groningen Groningen The Netherlands 4Department of Intensive Care Vrije Universiteit Medical Center Amsterdam The Netherlands Corresponding author Jack JM Ligtenberg j.j.m.ligtenberg@int.umcg.nl Published 27 June 2006 This article is online at http ccforum.com content 10 3 216 2006 BioMed Central Ltd Critical Care 2006 10 216 doi 10.1186 cc4957 Abstract Acute hyperglycaemia has been associated with complications prolonged intensive care unit and hospital stay and increased mortality. We made an inventory of the prevalence and prognostic value of hyperglycaemia and of the effects of glucose control in different groups of critically ill patients. The prevalence of hyperglycaemia in critically ill patients using stringent criteria approaches 100 . An unambiguous negative correlation between hyperglycaemia and mortality has been described in various groups of critically ill patients. Although the available evidence remains inconsistent there appears to be a favourable effect of glucose regulation. This effect on morbidity and mortality depends on patient characteristics. To be able to compare results of future studies involving glucose regulation better definitions of hyperglycaemia and consequently of normoglycaemia and patient populations are needed. Introduction Acute hyperglycaemia is frequently present in situations of stress both in diabetic and in nondiabetic patients 1-3 . Because it is so common it could be viewed as a physiologic