Published in:
01-12-2008 | Letter
Direct effects of modest hyperglycaemia on susceptibility to infection in the critically ill patient
Authors:
Matt P Wise, Anton G Saayman, Paul J Frost
Published in:
Critical Care
|
Issue 6/2008
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Excerpt
In their recent study, Otto and colleagues suggested that the adverse effects of hyperglycaemia on immune function may be mediated by hyperosmotic stress [
1]. In granulocytes both oxidative burst and phagocytosis were suppressed by hyperosmolar stress with mannitol, but no significant effect was observed on cytokine release from peripheral blood mononuclear cells [
1]. The concentration of glucose (and mannitol) used in these experiments (500 mg/dl or 27.8 mmol/l), however, is rarely encountered in critically ill patients – and then only transiently. One may question how relevant this mechanism is, when it appears that modest levels of hyperglycaemia (11.1 mmol/l) have deleterious effects in this population [
2]. …