Hyperglycemia can be a significant problem in the trauma population and has been shown to be associated with increased morbidity and mortality. Hyperglycemia in the trauma patient, as in other critically ill patients, is caused by a hypermetabolic response to stress and seems to be an entity of its own rather than simply a marker. Although several early studies in a mixed intensive care unit population indicated that insulin protocols aimed at strict glucose control improved outcome, later studies did not support this and, in fact, encountered increased complications due to hypoglycemia. More recent studies in the trauma population, while supporting the correlation between hyperglycemia and increased mortality, seemed to indicate that protocols aimed at moderate glucose control improved outcome while limiting the incidence of hypoglycemic complications.
SperryJLFrankelHLVanekSLNathensABMooreEEMaierRVMineiJP. Early hyperglycemia predicts multiple organ failure and mortality but not infection. J Trauma.2007;63 (3): 487–94.
2.
BochicchioGVScaleaTM. Glycemic control in the ICU. Adv Surg.2008;42: 261–75.
3.
LairdAMMillerPRKilgoPDMeredithJWChangMC. Relationship of early hyperglycemia in trauma patients. J Trauma.2004;56 (5);1058–62.
4.
Van den BergheGWutersPWeekersFVerwaestCBruyninckxFSchetzMVlasselaersDFerdinandePLauwersPBouillonR. Intensive insulin therapy in the critically ill patients. N Engl J Med.2001;345 (19): 1359–67.
5.
BrunkhorstFMEngelCBloosFMeier-HellmannARagallerMWeilerNMoererOGruendlingMOppertMGrondSOlthoffDJaschinskiUJohnSRossaintRWelteTSchaeferMKernPKuhntEKiehntopfMHartogCNatansonCLoefflerMReinhartK; German Competence Network Sepsis (SepNet). Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med.358 (2): 125–39.
6.
WienerRSWienerDCLarsonRJ. Benefits and risks of tight glucose control in critically ill adults: a meta-analysis. JAMA.2008;300 (8): 933–44.
7.
The NICE-SUGAR Study Investigators, FinferSChittockDRSuSYBlairDFosterDDhingraVBellomoRCookDDodekPHendersonWRHébertPCHeritierSHeylandDKMcArthurCMcDonaldEMitchellIMyburghJANortonRPotterJRobinsonBGRoncoJJ. Intensive versus conventional glucose control in critically ill patients. N Engl J Med.360 (13): 1283–97.
8.
DevosPLedouxDPreiserJC. Current practice of glycaemia control in European intensive care units: the GLUCONTROL Steering Committee [abstract]. Intensive Care Med.2005;31: 130.
9.
YendamuriSFuldaGTinkoffG. Admission hyperglycemia as a prognostic indicator in trauma. J Trauma.2003;55 (1): 33–8.
10.
SungJBochicchioGVJoshiMBochicchioKTracyKScaleaTM. Admission hyperglycemia is predictive of outcome in critically ill trauma patients. J Trauma.2005;59 (1): 80–3.
11.
BochicchioGVSalzanoLJoshiMBochicchioKScaleaTM. Admission preoperative glucose is predictive of morbidity and mortality in trauma patients who require immediate operative intervention. Am Surg.2005;71 (2): 171–4.
12.
BochicchioGVSungJJoshiMBochicchioKJohnsonSBMeyerWScaleaTM. Persistent hyperglycemia is predictive of outcome in critically ill trauma patients. J Trauma.2005;58 (5): 921–4.
13.
BochicchioGVJoshiMBochicchioKMPyleAJohnsonSBMeyerWLumpkinsKScaleaTM. Early hyperglycemic control is important in critically injured trauma patients. J Trauma.2007;63 (6);1353–9.
14.
ScaleaTMBochicchioGVBochicchioKMJohnsonSBJoshiMPyleA. Tight glycemic control in critically injured trauma patients. Ann Surg.2007;246 (4): 605–12.
15.
MerguerianPPerelAWaldUFeinsodMCotevS. Persistent nonketotic hyperglycemia as a grave prognostic sign in head-injured patients. Crit Care Med.1981;9 (12): 838–40.
16.
YoungBOttLDempseyRHaackDTibbsP. Relationship between admission hyperglycemia and neurologic outcome of severely brain injured patients. Ann Surg.1989;210 (4): 466–73.
17.
JeremitskyEOmertLDunhamCMProtetchJRodriguezA. Harbingers of poor outcome the day afer severe brain injury: hypothermia, hypoxia, and hypoperfusion. J Trauma.2003;54 (2): 312–9.
18.
OddoMSchmidtJMMayerSAChioléroRL. Glucose control after severe brain injury. Curr Opin Clin Nutr Metab Care.2008;11 (2): 134–9.
19.
AtiyehBSGunnSWDiboSA. Metabolic implications of severe burn injuries and their management: a systematic review of the literature. World J Surg.2008;32 (8): 1857–69.
20.
GoreDChinkesDHeggesJHerndonDNWolfSEDesaiM. Association of hyperglycemia with increased mortality after severe burn injury. J Trauma.51 (3): 540–4.
21.
HolmCHorbrandFMayrMvon DonnersmarckGHMühlbauerW. Acute hyperglycaemia following thermal injury: friend or foe?Resuscitation.60 (1): 71–7.
22.
PhamTNWarrenAJPhanHHMolitorFGreenhalghDGPalmieriTL. Impact of tight glycemic control in severely burned children. J Trauma.59 (5): 1148–54.
23.
CochranADavisLMorrisSESaffleJR. Safety and efficacy of an intensive insulin protocol in a burn-trauma intensive care unit. J Burn Care Res.29 (1): 187–91.
