A new horizon for insulin administration in the intensive care unit

Treatment of so-called stress-hyperglycaemia is usually neglected in the intensive care unit. However, there are good pathophysiological reasons to believe that this habit is unjustified. Insulin treatment may mitigate chronic inflammatory responses and oxidative stress. Moreover, an improvement of the immune function can be expected. Beneficial effects of insulin administration have already been found in the setting of cardiac surgery and acute myocardial infarction. Other indications in which a beneficial effect may be expected include vascular surgery, transplantation, systemic inflammatory response syndrome, and intravenous usage of X-ray contrast media.