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In addition to intrinsic changes in glucose metabolism and development of insulin resistance, specific intensive care unit (ICU) practices may influence the development of SH during critical illness. Mechanical ventilation, vasoactive infusions, renal replacement therapies, cardiopulmonary bypass and extracorporeal life support, therapeutic hypothermia, prolonged immobility, nutrition support practices, and the use of medications are all known to mediate development of SH in critical illness. Tight glucose control (TGC) to manage SH has emerged as a promising therapy to improve outcomes in critically ill adults, but results have been inconclusive. Large variations in ICU practices across studies likely resulted in inconsistent results. Future studies of TGC need to take into account the impact of commonly used ICU practices and, ideally, standardize protocols in an attempt to improve the accuracy of conclusions from such studies.<\/jats:p>","DOI":"10.1177\/193229681200600106","type":"journal-article","created":{"date-parts":[[2014,1,10]],"date-time":"2014-01-10T10:35:52Z","timestamp":1389350152000},"page":"37-47","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":52,"title":["Stress Hyperglycemia in Pediatric Critical Illness: The Intensive Care Unit Adds to the Stress!"],"prefix":"10.1177","volume":"6","author":[{"given":"Vijay","family":"Srinivasan","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, 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