Articles: critical-illness.
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Journal of critical care · Aug 2023
ReviewPhysiological and clinical effects of different infusion rates of intravenous fluids for volume expansion: A scoping review.
To assess the physiological and clinical effects of different rates of intravenous fluids for volume expansion of critically ill and perioperative patients. ⋯ In this scoping review, most studies showed that slower intravenous infusion rates result in a more efficient intravascular expansion, with a longer effect, and less edema than faster rates. Effects on clinical outcomes were inconsistent.
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Curr Opin Crit Care · Aug 2023
ReviewInsulin resistance in critical illness: consequences for nutrition therapy and glucose management.
Critically ill patients usually develop insulin resistance and hyperglycemia, which is aggravated by early parenteral nutrition. In observational studies, the lowest mortality risk associates with glucose concentrations close to the antecedent average glucose level. This review summarizes the most recent evidence regarding glucose control in critical illness. ⋯ It remains unclear whether tight glucose control in critical illness is beneficial or not in the absence of early parenteral nutrition, which is currently being studied in the multicenter TGC-fast randomized controlled trial. Without new evidence, it seems prudent to avoid severe hyperglycemia and hypoglycemia in all patients.