О.Н. Исачкина, Л.И. Данилова
Учреждение здравоохранения «10-я городская клиническая больница», Государственное учреждение образования «Белорусская медицинская академия последипломного образования»
Дисгликемия (в форме гипер- и гипогликемии, а также - неадекватной вариабельности параметров гликемии) развивается у большинства пациентов в критическом состоянии вне зависимости от наличия в анамнезе верифицированного диагноза сахарного диабета. Нарушения параметров гликемии у таких пациентов ассоциированы с возрастанием смертности и осложнений. Результаты наблюдений последних десятилетий подтверждают, что качественный гликемический контроль улучшает клинические исходы в этой группе пациентов. Многоцентровые исследования не подтвердили преимуществ «жесткого» контроля величин гликемии. И в настоящее время принято общее положение избегать гипергликемии (>10,0 ммоль/л) и тяжелой гипогликемии (<2,2 ммоль/л) у пациентов в критическом состоянии. В обзоре рассматриваются вопросы эпидемиологии, патофизиологии и коррекции дисгликемии у пациентов в критическом состоянии.
ключевые слова: дисгликемия, стрессовая гипергликемия, сахарный диабет, критические состояния, гликемический контроль

для цитирования: О.Н. Исачкина, Л.И. Данилова. Дисгликемия критических состояний. Неотложная кардиология и кардиоваскулярные риски. 2018, Т. 2. № 2. С. 302-311

Dysglycemia of critical conditions
O.N. Isachkina, L.I. Danilova
Dysglycemia develops in the form of hyperglycemia, hypoglycemia and marked glucose variability in critically ill adults whether they are known to have premorbid diabetes or not. Patients with such glucose dysregulation have increased morbidity and mortality. Substantial data obtained over the past decade provide evidence that quality glucose management in these individuals improves clinical outcomes. Multicentre trials did not confirm the benefits of tight control of blood glucose. The general consensus now is that excessive hyperglycemia (>10 mmol/L) and severe hypoglycemia (<2.2 mmol/L) should be avoided in critically ill adults. This review describes the epidemiology, pathophysiology and management of dysglycemia in critically ill patients.
keywords: dysglycemia, stress hyperglycemia, diabetes mellitus, critical illness, glycemic control

for references: O.N. Isachkina, L.I. Danilova. Dysglycemia of Critical Conditions. Emergency Cardiology and Cardiovascular Risks. 2018, vol. 2, № 2, pp. 302-311

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