Pro/con debate: Is intensive insulin therapy targeting tight blood glucose control of benefit in critically ill patients?
نویسندگان
چکیده
You have decided to develop a protocol for insulin therapy in your intensive care unit (ICU). You wonder about the merit of using intensive insulin therapy (IIT) to maintain tight blood glucose control in your patients.
منابع مشابه
Tight blood glucose control: a recommendation applicable to any critically ill patient?
The issue of tight glucose control with intensive insulin therapy in critically ill patients remains controversial. Although compelling evidence supports this strategy in postoperative patients who have undergone cardiac surgery, the use of tight glucose control has been challenged in other situations, including in medical critically ill patients and in those who have undergone non-cardiac surg...
متن کاملIntensive insulin therapy and mortality in critically ill patients
BACKGROUND Since Van den Berghe et al published their study on tight glucose control in 2001, intensive insulin therapy (IIT) has been increasingly used for critically ill patients worldwide. However, recent studies reported a significantly increased risk of hypoglycemia without a significant reduction in mortality. OBJECTIVE The purpose of this article was to evaluate the effect of IIT with ...
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Intensive insulin therapy (IIT) for hyperglycemia in critically ill patients has become a standard practice. Target levels for glycemia have fluctuated since 2000, as evidence initially indicated that tight glycemic control to so-called normoglycemia (80-110 mg/dl) leads to the lowest morbidity and mortality without hypoglycemic complications. Subsequent studies have demonstrated minimal clinic...
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Hyperglycemia is a common problem encountered in hospitalized patients, especially in critically ill patients and those with diabetes mellitus. Uncontrolled hyperglycemia may be associated with complications such as fluid and electrolyte disturbances and increased infection risk. Studies have demonstrated impairment of host defenses, including decreased polymorphonuclear leukocyte mobilization,...
متن کاملTight glycaemic control: a prospective observational study of a computerised decision-supported intensive insulin therapy protocol
INTRODUCTION A single centre has reported that implementation of an intensive insulin protocol, aiming for tight glycaemic control (blood glucose 4.4 to 6.1 mmol/l), resulted in significant reduction in mortality in longer stay medical and surgical critically ill patients. Our aim was to determine the degree to which tight glycaemic control can be maintained using an intensive insulin therapy p...
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ورودعنوان ژورنال:
- Critical Care
دوره 12 شماره
صفحات -
تاریخ انتشار 2008