Rôle de l'insuline et du contrôle de la glycémie en réanimation

Hyperglycemia is a common feature of the critically ill and has been associated with increased mortality. Maintaining normoglycemia with insulin therapy improves survival and reduces morbidity in prolonged critically ill patients in both surgical and medical ICU, as shown by two large randomized controlled studies. Prevention of cellular glucose toxicity by strict glycemic control appears to play a predominant role, but also other metabolic and non-metabolic effects of insulin appear to contribute to the clinical benefits.