الفهرس 
Pathophysiology of Sepsis in Critically ill PatientsOnly 14 pages are availabe for public view
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Abstract
Introduction: There are many pathophysiological changes during severe sepsis and septic shock, and one of the most striking is metabolic derangement. Among the metabolic changes, hyper-glycemia is the most important. increased glucose uptake is mediated by effects of the counterregulatory hormones and by cytokine effects. Gluconeogenesis is a main factor in the hyperglycemic response (Figure 2), increased gluconeogenesis is supplied by stimulated Cori cycle activity and enhanced glucose–alanine cycle turnover. Additional effectors of increased gluconeogenesis are counterregulatory hormones and direct cytokine stimulation. Aim of the Work: This study will be conducted to discuss sepsis and its metabolic changes in critical ill patient, and to study the impact of glycemic control in the prognosis of sepsis among these patients. Conclusion: The health benefits of moderate glucose level targets (140–200 mg/dl) should be examined. Further multicenter trials including a larger number of patients are necessary to define the optimal target range of blood glucose for IIT with the best benefit-to-risk ratio. However, highly accurate glucose measurements and insulin administration protocols among institutions should be standardized to avoid heterogeneity in results.