European Stroke Organisation (ESO) guidelines on glycaemia management in acute stroke

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European Stroke Org , Fuentes , B , Ntaios , G , Putaala , J , Thomas , B , Turc , G & Diez-Tejedor , E 2018 , ' European Stroke Organisation (ESO) guidelines on glycaemia management in acute stroke ' , European Stroke Journal , vol. 3 , no. 1 , pp. 5-21 . https://doi.org/10.1177/2396987317742065

Title: European Stroke Organisation (ESO) guidelines on glycaemia management in acute stroke
Author: European Stroke Org; Fuentes, Blanca; Ntaios, George; Putaala, Jukka; Thomas, Brenda; Turc, Guillaume; Diez-Tejedor, Exuperio
Other contributor: University of Helsinki, Department of Neurosciences



Date: 2018-03
Language: eng
Number of pages: 17
Belongs to series: European Stroke Journal
ISSN: 2396-9873
DOI: https://doi.org/10.1177/2396987317742065
URI: http://hdl.handle.net/10138/299278
Abstract: Background Hyperglycaemia is a frequent complication in acute stroke that has been shown to be independently associated with larger infarct size, haematoma growth, poor clinical outcome and mortality. This Guideline Document presents the European Stroke Organisation (ESO) Guidelines for the management of blood glucose levels in patients with acute ischemic or haemorrhagic stroke. Methods The working group identified related questions and developed its recommendations based on evidence from randomised controlled trials following the standard operating procedure of the ESO. This Guideline Document was reviewed and approved by the European Stroke Organisation Guidelines Committee and the European Stroke Organisation Executive Committee. Results We found low-quality evidence from clinical trials in ischemic or haemorrhagic stroke exploring the use of intravenous insulin aimed to achieve a tight glycaemic control with different glucose level targets and several other sources of heterogeneity. None of these trials neither the meta-analysis of them have demonstrated any significant benefit of tight glycaemic control with intravenous insulin in acute ischemic or haemorrhagic stroke patients on functional outcome or in survival and they have shown an increased risk for hypoglycaemia. Conclusions We suggest against the routine use of tight glycaemic control with intravenous insulin as a means to improve outcomes. The currently available data about the management of glycaemia in patients with acute stroke are limited and the strengths of the recommendations are therefore weak. Nevertheless, this does not prevent that hyperglycaemia in acute stroke patients could be treated as any other hospitalised patient.
Subject: Acute stroke
hyperglycaemia
guidelines
GRADE
European Stroke Organisation
ACUTE ISCHEMIC-STROKE
CRITICALLY-ILL PATIENTS
SPONTANEOUS INTRACEREBRAL HEMORRHAGE
POTASSIUM-INSULIN INFUSIONS
ADMISSION BLOOD-GLUCOSE
POSTSTROKE HYPERGLYCEMIA
INTRAVENOUS THROMBOLYSIS
SERUM GLUCOSE
TRIAL GIST
SHORT-TERM
3112 Neurosciences
3124 Neurology and psychiatry
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