Glycemic Control and Stress Ulcer Prophylaxis

The glycemic state in sepsis is a complex interplay of multiple factors leading to glucose dysregulation and hyperglycemia. The recent Surviving Sepsis Campaign 2021 guidelines strongly recommend initiation of insulin therapy for glucose levels >180mg/dL (10mmol/L) with a typical target blood glucose range of 144–180mg/dL (8–10mmol/L). Patients with sepsis or septic shock may have several risk factors for stress ulcers and bleeding. Current guidelines suggest stress ulcer prophylaxis for patients with sepsis who have risk factors for gastrointestinal bleeding. Either proton pump inhibitors or histamine H-2 receptor antagonists can be used for stress ulcer prophylaxis.