Effects of Hyperglycemia on Neurologic Outcome in Stroke Patients

Alison S. Paolino; Krista M. Garner

Disclosures

J Neurosci Nurs. 2005;37(3):130-135. 

In This Article

Introduction

Hyperglycemia in critically ill patients has been described as a "toxic metabolic milieu" that slowly and insidiously results in increased morbidity and mortality. The presence of hyperglycemia in acute stroke increases cerebral infarct size and subsequently worsens neurologic outcome (Parsons et al., 2002). Hyperglycemia is a common problem in the stroke population. It is estimated that 20%-50% of acute stroke patients—even those without preexisting DM—present with a concurrent diagnosis of hyperglycemia (Alvarez-Sabín et al., 2003). Controlling hyperglycemia with a continuous insulin infusion to reach euglycemic levels has been shown to decrease morbidity and mortality. This article reviews the pathophysiology of hyperglycemia, its effects on injured brain tissue, and overall neurologic outcome. Hyperglycemic treatment strategies also are discussed, as well as issues with which neuroscience nurses should be familiar to provide optimal care for stroke patients with hyperglycemia.

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