Glycaemic Control in the Critically Ill: What Have We Learned Since NICE-SUGAR?

Glycaemic control of the critically ill has been a topic of considerable interest in the critical care community since the publication of a single-centre randomised controlled trial (RCT) of intensive insulin therapy (IIT) targeting euglycaemia, blood glucose (BG) 80-110 mg/dL, in a population of mechanically ventilated surgical intensive care unit (ICU) patients, 63% of whom had undergone cardiovascular surgery (Van den Berghe et al. 2003). However, the dramatic reductions in mortality and morbidity demonstrated in this investigation were not reproduced in subsequent trials (Van den Berghe et al. 2006; Brunkhorst et al. 2008; Preiser et al. 2009; Arabi