Critically ill patients: Tight glucose control using intensive insulin therapy
DISEASE INTERVENTION COMPARISON RESULTS
JAMA. 2008 Aug 27;300(8):933-44 Meta-Analysis
IN critically ill patients The Use of
tight glucose control, intensive insulin therapy
As Treatment, Acute
Is worse Than
usual glycemic control
To to reduce hospital mortality (21.6% tight control VS 23.3% usual care) but increased hypoclycemia (13.7% tight control VS 2.5% usual care)
N Engl J Med. 2006 Feb 2;354(5):449-61 Randomized Controlled Trial, Multicenter Study
IN critically ill patients, multiple-organ failure, non-surgical patients The Use of
intensive insulin therapy, insulin infusion to get glycaemia 4.4 to 6 mmol/L
As Treatment, Acute
Is equal Than
conventional treatment, insulin only if very high glycaemia (>12 mmol/L)
To affect mortality: 37.3% in conventional insuline VS 40% with intensive insuline.
N Engl J Med. 2001 Nov 8;345(19):1359-67 Randomized Controlled Trial
IN critically ill patients, multiple-organ failure, septic shock The Use of
intensive insulin therapy
As Treatment, Acute
Is better Than
conventional treatment, insulin only if very high glycaemia (>12 mmol/L)
To reduce mortality at 1 year: 4.6% with intensive VS 8% with conventional