A 50-year-old critically ill surgical patient on mechanical ventilation has persistent hyperglycemia (blood glucose 240 mg/dL) despite standard insulin protocol. According to the NICE-SUGAR trial findings, what is the recommended glucose target in critically ill patients?

• A 80-110 mg/dL (tight glycemic control)
• B No specific target; treat only if >300 mg/dL
• C 200-220 mg/dL (permissive hyperglycemia)
• D 140-180 mg/dL ✓

Explanation

The NICE-SUGAR trial (2009) demonstrated that tight glycemic control (80-110 mg/dL) increased mortality compared to moderate control (140-180 mg/dL) in critically ill patients, largely due to increased hypoglycemic episodes. Current guidelines recommend maintaining blood glucose between 140-180 mg/dL in critically ill surgical patients. Hypoglycemia is particularly dangerous in sedated ICU patients and is associated with increased mortality.

Reference: NICE-SUGAR Study, NEJM, 2009 ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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