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Endocrine Perturbations in Critical Illness

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Surgical Metabolism

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Abstract

Acute illness results in an increase in circulating concentrations of stress hormones, including adrenaline and cortisol, which impair insulin action, thereby leading to hyperglycemia. Extensive evidence from observational studies reveals a strong correlation between hyperglycemia during critical care and patient outcomes, including mortality. Even when controlling for other markers of severity of illness, the degree of blood glucose elevation appears to be independently associated with adverse events. Importantly, the relationship between glucose and mortality appears to be more tightly linked in patients without a prior history of diabetes—i.e., in those with newly identified hyperglycemia. It remains debated, however, as to whether hyperglycemia during critical illness is a marker for or a mediator of patient outcomes.

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Authors and Affiliations

  1. Department of Medicine, Section of Endocrinology, Yale University School of Medicine, New Haven, CT, USA

    Grace S. Lee MD, Silvio E. Inzucchi MD & Elizabeth H. Holt MD, PhD

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  1. Grace S. Lee MD
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  2. Silvio E. Inzucchi MD
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  3. Elizabeth H. Holt MD, PhD
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Correspondence to Elizabeth H. Holt MD, PhD .

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Editors and Affiliations

  1. Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA

    Kimberly A. Davis

  2. Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut, USA

    Stanley H. Rosenbaum

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Lee, G.S., Inzucchi, S.E., Holt, E.H. (2014). Endocrine Perturbations in Critical Illness. In: Davis, K., Rosenbaum, S. (eds) Surgical Metabolism. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1121-9_14

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