Document Detail


Intensive insulin therapy to non-cardiac ICU patients: a prospective study.
MedLine Citation:
PMID:  16805937     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Intensive insulin therapy reduced mortality in patients admitted to an intensive care unit following mainly cardiac surgery. The aim of this prospective study was to evaluate, if intensive insulin therapy could reduce mortality in medical and non-cardiac surgical patients admitted to a multidisciplinary intensive care unit. PATIENTS AND METHODS: For 6 months all adult patients, admitted to the intensive care unit, were included. Insulin was administered, if blood glucose 12 mmol L-1. For the next 6 months blood glucose level was reduced with intensive insulin therapy (aim 4.4 < BG < 6.1 mmol L-1); 271 patients were included. Patient characteristics data, APACHE II score, morbidity and mortality were recorded. RESULTS: At admission the two groups were comparable. The overall relative mortality was reduced 20% in the intensive insulin treated group (n.s.). In the intensive insulin treated group mortality was 13.1% in the medical patients and 11.2% in the surgical patients compared to 15.8% and 14.4%, respectively, in the conventional treated group (n.s.). The frequency of secondary infections was 21.5% in the intensive insulin treated group and 16.0% in the conventional treated group (n.s.). The proportion of hypoglycaemia increased from 4% to 14% (P < 0.05). CONCLUSIONS: Following intensive insulin therapy there was a trend towards reduced mortality in medical and non-cardiac surgical patients but less pronounced as in cardiac surgical patients. Intensive insulin therapy increased the frequency of hypoglycaemia. Around 4400 patients would have to be included in any future randomized study to reach significance.
Authors:
P Toft; H S Jørgensen; E Toennesen; C Christiansen
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  23     ISSN:  0265-0215     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-06-29     Completed Date:  2007-12-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  705-9     Citation Subset:  IM    
Affiliation:
Aarhus University Hospital, Department of Anaesthesiology and Intensive Care, Aarhus, Denmark. palle.toft@ouh.fyns-amt.dk
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Glucose / drug effects
Female
Humans
Hyperglycemia / drug therapy*,  prevention & control
Hypoglycemia / chemically induced
Insulin / administration & dosage*,  adverse effects,  standards
Intensive Care Units* / standards
Male
Middle Aged
Prospective Studies
Survival Rate
Treatment Outcome
Chemical
Reg. No./Substance:
0/Blood Glucose; 11061-68-0/Insulin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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