Blood Sugar Levels in Traumatic Brain Injury Patients
Author Information
Author(s): Regula Meier, Markus Béchir, Silke Ludwig, Jutta Sommerfeld, Marius Keel, Peter Steiger, Reto Stocker, John F Stover
Primary Institution: University Hospital Zuerich
Hypothesis
Maintaining arterial blood glucose between 3.5 to 6.5 mmol/l, as compared with 5 to 8 mmol/l, significantly decreases mortality and reduces rates of infectious complications.
Conclusion
Lower blood glucose levels (3.5 to 6.5 mmol/l) may be beneficial during the second week after severe traumatic brain injury, but higher levels (5 to 8 mmol/l) are more favorable during the first week.
Supporting Evidence
- Lower blood glucose levels were associated with increased rates of hypoglycaemic episodes.
- Mortality rates were similar between the two blood glucose target groups.
- Increased insulin and norepinephrine requirements were noted in the lower blood glucose group.
- The incidence of intracranial pressure exceeding 20 mmHg was significantly decreased in the lower blood glucose group during the second week.
Takeaway
Doctors are trying to find the best blood sugar levels for patients with serious brain injuries. Keeping it lower might help after a week, but higher levels are better at first.
Methodology
Retrospective evaluation of 228 propensity-matched patients treated in an ICU from 2000 to 2004, comparing two blood glucose targets.
Potential Biases
Potential bias from not controlling for clinically important interventions and changes in treatment over time.
Limitations
The study is retrospective and may miss important changes due to only documenting parameters at 4-hour intervals.
Participant Demographics
114 men and 114 women, ages 18 to 81, with various types of traumatic brain injuries.
Statistical Information
P-Value
p<0.05
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
Want to read the original?
Access the complete publication on the publisher's website