ABSTRACT
Melissa
Knieriem, DVM, DACVECC; Cynthia M. Otto, DVM, PhD, DACVECC; Douglass Macintire,
DVM, MS, DACVIM, DACVECC
Hyperglycemia is common in critically ill
humans. Recent clinical trials have shown a
significant reduction in morbidity and mortality
rates with the use of intensive insulin therapy to maintain strict
normoglycemia in critically ill patients. Hyperglycemia is associated with many
detrimental effects, including reduced immune function, increased inflammation
and coagulation, and modulation of the endothelium. Most of the evidence
regarding the adverse effects of hyperglycemia is
derived from humans with diabetes, cardiac
failure, or traumatic brain injury. In addition to its anabolic effects on
metabolism, insulin has antiinflammatory properties.To define the potential
risks and benefits of intensive insulin therapy in critically ill animals,
prospective, randomized clinical trials are necessary.
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