Intensive Insulin Therapy in Critically Ill Patients

doi:10.1056/nejm200205163462016

Cited by 26 publications

(2 citation statements)

References 56 publications

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“…Among trauma intensive care unit patients, those with low blood glucose levels (4.4 to 6.1 mmol/L) appear to have lower morbidity and mortality than those with high blood glucose concentrations (exceeding 12 mmol/L), and low glucose levels have been associated with reduced incidences of critical illness polyneuropathy, bacteremia, acute renal failure, etc. [14]. High glucose (HG) has been reported to amplify the brain contusion volume and suppress neutrophil and macrophage infiltration on post-injury days 1-90, thus exacerbating neurological functional deterioration and inducing apoptosis [10].…”

Section: Introductionmentioning

confidence: 99%

“…High glucose (HG) has been reported to amplify the brain contusion volume and suppress neutrophil and macrophage infiltration on post-injury days 1-90, thus exacerbating neurological functional deterioration and inducing apoptosis [10]. However, other studies have shown that modestly high blood glucose allows neuronal cells to acquire sufficient energy to prevent secondary brain damage [12,14]. Thus, the influence of hyperglycemia on inflammation and programmed cell death in the post-trauma period, especially the intermediate stage, is not clear at this point.…”

Section: Introductionmentioning

confidence: 99%

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High glucose exacerbates neuroinflammation and apoptosis at the intermediate stage after post-traumatic brain injury

Zhang

Hong

Zheng

et al. 2021

Aging

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Traumatic brain injury (TBI) is a highly lethal event with a poor prognosis. Recovering residual neuronal function in the intermediate stage of TBI is important for treatment; however, neuroinflammation and neuronal apoptosis impede residual neuronal repair processes. Considering that hyperglycemia influences inflammatory processes and neuronal survival, we examined the effects of high glucose on neuroinflammation and neuronal death during the intermediate phase of TBI. Rat models of type 2 diabetes mellitus and/or TBI were developed and behaviorally assessed. Neurological function and cognitive abilities were impaired in TBI rats and worsened by type 2 diabetes mellitus. Histopathological staining and analyses of serum and hippocampal mRNA and protein levels indicated that neuroinflammation and apoptosis were induced in TBI rats and exacerbated by hyperglycemia. Hyperglycemia inhibited hippocampal mitogen-activated protein kinase kinase 5 (MEK5) phosphorylation in TBI rats. In vitro assays were used to assess inflammatory factor expression, apoptotic protein levels and neuronal survival after MEK5 activation in TBI-and/or high-glucosetreated neurons. MEK5/extracellular signal-regulated kinase 5 (ERK5) pathway activation reduced the inflammation, cleaved caspase-3 expression, Bax/Bcl-2 ratio and apoptosis of TBI neurons, even under highglucose conditions. Thus, high glucose exacerbated neuroinflammation and apoptosis in the intermediate stage post-TBI by inhibiting the MEK5/ERK5 pathway.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

High glucose exacerbates neuroinflammation and apoptosis at the intermediate stage after post-traumatic brain injury

Zhang

Hong

Zheng

et al. 2021

Aging

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Evidence‐based sepsis therapy: A hospitalist perspective

Jenkins

2006

Journal of Hospital Medicine

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Guidelines for the optimization of microsurgery in atherosclerotic patients

et al. 2006

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We review the pathogenesis of atherosclerosis and the issues that must be taken into consideration when performing microsurgery in atherosclerotic patients. Atherosclerosis is a systemic disease, and may affect the success of microsurgery. Atherosclerotic patients have a tendency toward thrombosis, because the nature of the arteries is changed. Such patients are usually old and have additional medical problems. To increase the success rate of microsurgery in atherosclerotic patients, special precautions should be considered. Patients must be evaluated properly for the suitability of microsurgery. The microsurgical technique requires a meticulous approach, and various technical tricks can be used to avoid thrombosis. Recipient-vessel selection, anastomotic technique, and the use of vein grafts are all important issues. Prophylactic anticoagulation is recommended in severely atherosclerotic patients. Close monitoring of the patient and flap is necessary after the operation, as with routine microvascular free-tissue transfers. We conclude that atherosclerosis is not a contraindication for microsurgery. If the microsurgeon knows how to deal with the difficulties in atherosclerotic patients, microsurgery can be performed safely.

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Intensive Insulin Therapy in Critically Ill Patients

Cited by 26 publications

References 56 publications

High glucose exacerbates neuroinflammation and apoptosis at the intermediate stage after post-traumatic brain injury

High glucose exacerbates neuroinflammation and apoptosis at the intermediate stage after post-traumatic brain injury

Evidence‐based sepsis therapy: A hospitalist perspective

Guidelines for the optimization of microsurgery in atherosclerotic patients

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