Vriesendorp et al identified risk factors associated with hypoglycemic in the intensive care unit. Recognition of these factors allows for an early intervention. The authors are from the Academic Medical Center in Amsterdam and Leiden University in the Netherlands.


Management factors:

(1) continuous venovenous hemofiltration using a bicarbonate-based substitution fluid

(2) administration of insulin

(2a) failure to adjust insulin administration for a decrease in nutrition

(2b) co-administration with octreotide

(3) need for inotropic support



• A lactate-based substitution fluid can be used rather than the bicarbonate-based fluid.

• Continuous venovenous hemofiltration indicates renal dysfunction.


Patient factors:

(1) history of diabetes mellitus

(2) sepsis


A patient with one or more of these risk factors should be monitored more closely for hypoglycemia. Early detection allows for early correction, which can avoid serious consequences.


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