Hyperglycemia with simultaneous cerebral ischemia is associated with detrimental clinical sequelae in some neurosurgical patients. These include a longer intensive care unit stay, poor recovery of neurologic function, symptomatic cerebral vasospasm, and increased cerebral infarct size. Intensive insulin therapy (IIT) may improve outcomes in hyperglycemic neurosurgical patients. The adoption of IIT has been limited by a lack of adequate data on optimal insulin delivery protocols and serum glucose concentration and by concerns about the risks of hypoglycemia. Therapeutic interventions to lower glucose levels to a tight range (80â120 mg/dl) with intensive insulin therapy (IIT) have been studied in a variety of critical care settings with mixed results.
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Last date updated on August, 2020