Invited Review Management of Parenteral Nutrition in Acutely Ill Patients With

ABSTRACT: Many hospital clinicians manage patients with hyperglycemia receiving nutrition support. Recent studies underscore the importance of tight glucose control in hospitalized patients. Over the short term, hyperglyce-mia can adversely affect fluid balance, immune function, inflammation, and outcome; glucose control can improve these effects. Because this appears to be true for patients with and without a known diagnosis of diabetes, hyper-glycemia should be aggressively treated in all patients. Avoidance or minimization of hypoglycemia also is impor-tant. In general, the nutrition assessment, indications for nutrition support, and estimate of nutrition requirements for critically ill patients with hyperglycemia are similar to those of nondiabetic patients. Because overfeeding may cause hyperglycemia, appropriate provision of calories i