Strict Glycaemic Control in ICU Patients
Author Information
Author(s): Gisela Del Carmen De La Rosa, Jorge Hernando Donado, Alvaro Humberto Restrepo, Alvaro Mauricio Quintero, Luis Gabriel González, Nora Elena Saldarriaga, Marisol Bedoya, Juan Manuel Toro, Jorge Byron Velásquez, Juan Carlos Valencia, Clara Maria Arango, Pablo Henrique Aleman, Esdras Martin Vasquez, Juan Carlos Chavarriaga, Andrés Yepes, William Pulido, Carlos Alberto Cadavid
Primary Institution: Hospital Pablo Tobon Uribe
Hypothesis
Does intensive insulin therapy decrease morbidity and mortality in patients hospitalized in a mixed medical/surgical ICU compared to standard therapy?
Conclusion
Intensive insulin therapy did not reduce morbidity or mortality in patients admitted to a mixed medical/surgical ICU and increased the risk of hypoglycaemia.
Supporting Evidence
- 28-day mortality was 32.4% in the standard insulin group and 36.6% in the intensive insulin group.
- ICU mortality rates were similar between the two groups.
- The rate of hypoglycaemia was significantly higher in the intensive insulin group.
Takeaway
The study found that trying to keep blood sugar levels very low in ICU patients didn't help them get better and actually made some of them have dangerously low blood sugar.
Methodology
A prospective, randomised, non-blinded, single-centre clinical trial comparing intensive insulin therapy with standard therapy in a mixed ICU.
Potential Biases
The inability to maintain blinding due to glucose monitoring may introduce bias.
Limitations
The study was underpowered to detect differences and was conducted in a single center, limiting generalizability.
Participant Demographics
Patients aged 15 years or older, with a mean age of 47 years, included both medical and surgical patients.
Statistical Information
P-Value
p<0.05
Confidence Interval
95% CI: 0.85 to 1.42
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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