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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
Minerva Anestesiologica 2015 September;81(9):1010-18
Blood glucose amplitude variability in critically ill patients
Intensive Care Medicine, University Hospitals Leuven, Leuven, Belgium
While the discussion on the optimal blood glucose (BG) level target in critically ill patients is on-going, attention shifts towards other aspects of the BG signal, such as hypoglycemia and blood glucose amplitude variability (BGAV). A large number of observational and mostly retrospective studies have demonstrated an association between increased BGAV and worse outcomes. This observed association could partially be explained by endogenous factors such as changes in the status of the patient that cannot be externally influenced. On the other hand, exogenous factors such as insulin and caloric infusions could play a role in increasing or decreasing BGAV. In this review article, intuitive concept of “variability” will be clarified, and possible metrics to quantify BGAV are discussed. Whether it is feasible to actively minimize BGAV in order to improve the outcome of critically ill patients, is questionable.