Is it time for implementation of tight glycaemia control by intensive insulin therapy in every ICU?
نویسندگان
چکیده
The second study on tight glycaemia control by intensive insulin therapy (IIT) confirmed in medical intensive care unit patients the decrease in hospital mortality reported by the same team in the first IIT trial in surgical patients. However, methodological concerns, the high rate of hypoglycaemia in spite of the infusion of large doses of parenteral glucose and the frequent use of steroids presently preclude considering these results as recommendations in other intensive care units, but rather argue for the need for large-scale assessment of the IIT approach by multi-centre studies to confirm the efficacy and safety of this therapeutic modality.
منابع مشابه
Tight 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...
متن کاملImplementing an intravenous insulin infusion protocol in the intensive care unit.
PURPOSE The implementation of three different insulin protocols in intensive care unit (ICU) settings in two community hospitals and one academic hospital is described. SUMMARY Each institution possessed a commitment to improve the existing insulin protocols in order to achieve tighter glycemic control for ICU patients. Studies have shown that the maintenance of tight glycemic control provide...
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Over the past years there has been a significant decrease in mortality and morbidity in patients suffering from severe burns due to improved burn wound management and approaches in critical care. Survival is no longer the exception, but unfortunately death still occurs. One of the key elements concerning state-of-the-art burn care is blood glucose control and insulin therapy; it is well known t...
متن کاملIntensive insulin protocol improves glucose control and is associated with a reduction in intensive care unit mortality.
BACKGROUND Intensive insulin therapy to maintain serum glucose levels between 80 and 110 mg/dL has previously been shown to reduce mortality in the critically ill; recent data, however, have called this benefit into question. In addition, maintaining uniform, tight glucose control is challenging and resource demanding. We hypothesized that, by use of a protocol, tight glucose control could be a...
متن کاملPro/con debate: Is intensive insulin therapy targeting tight blood glucose control of benefit in critically ill patients?
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.
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عنوان ژورنال:
- Critical Care
دوره 10 شماره
صفحات -
تاریخ انتشار 2006