Hyperglycemia in ICU

Q: Hyperglycemic response to dextrose containing fluid infusion in ICU patients is usually exaggerated. What are the reasons behind it?

Answer:  It is not a surprise that infusion of dextrose-containing solutions can cause hyperglycemia, but this response is exaggerated particularly in ICU patients. This is due to two other added mechanisms.

1. counter-regulatory hormone response i.e. increased epinephrine secretion. 
2. cytokine responses

These all combined effect leads to hyperglycemia much higher than expected.


#electrolyte
#endocrine


References:

1. McCowen KC, Malhotra A, Bistrian BR. Stress-induced hyperglycemia. Crit Care Clin 2001; 17:107. 

2. Wolfe RR, Allsop JR, Burke JF. Glucose metabolism in man: responses to intravenous glucose infusion. Metabolism 1979; 28:210.