الفهرس 
Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
Critical illness is often characterized by hyperglycemia
and insulin resistance. Hyperglycemia may have detrimental
effects at the cellular level and contribute to organ failure,
morbidity and ultimately death. This was most pronounced in
patients with a demonstrable septic focus.
Recent publications demonstrated the beneficial
effects of strictly maintaining normoglycemia in ICU
patients by administration of intensive insulin therapy. A
significant reduction in mortality of ICU patients was
observed, particularly of those with prolonged critical illness.
Furthermore, intensive insulin therapy was able to protect
against acute renal failure, the development of critical illness,
polyneuropathy, also partially counteracted the deranged
serum lipid profile and impaired immunity seen in critically
ill patients.
Microalbuminuria is a common finding in critically ill
patients, where it has shown promise not only as a predictor of
organ failure and vasopressor requirement, but also of
mortality, faring better than Acute Physiological and chronic
Health Evaluation (APACHE) II score and Sequential Organ
Function Assessment (SOFA) score.
This research studied the effect of the application of
tight glycemic control protocol (group I, 30 patients) on
microalbuminuria and organ failure in severe sepsis, with
conventional glycemic control (group II, 30 patients) during
the first 7 days of their stay in ICU.
All patients were continuously monitored for blood
glucose level, vital signs and SOFA score.
Results showed less morbidity in the tight glycemic
control group. This was confirmed by reduction in SOFA
score, microalbuminuria and ICU stay in TGC group.
from our results, we concluded that application of
tight glycemic control protocols using continuous
intravenous insulin infusion could be a safe, cheap and
effective therapeutic modality in reducing ICU morbidity in
severe sepsis and there are positive correlation between
MACR and SOFA score which led us to focus on
microalbuminuria as an early marker in severe sepsis.