[Insulin therapy on intensive care should not be too intensive].
Intensive insulin therapy for critically ill patients is implemented as standard therapy in many ICUs, even though the evidence supporting this approach comes from just two studies at a single centre. Moreover, the results could not be repeated in other multicenter trials and there is increasing evidence of a risk of hypoglycaemia. However, it appears that many intensive care specialists have been too zealous in their attempts to attain euglycemia during critical care. A recent RCT with over 6000 patients demonstrated that intensive glucose control increases mortality by 2.4%.
VU Medisch Centrum, afd. Intensive Care Volwassenen, Amsterdam, The Netherlands. arj.girbes@vumc.nl
Armand R J
AR
Girbes
Albertus
A
Beishuizen
D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000401:mortality / Q000628:therapy*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced* / Q000401:mortality; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use; D007328:Insulin / Q000009:adverse effects* / Q000627:therapeutic use*; D007362:Intensive Care Units; D018570:Risk Assessment; D012308:Risk Management
D007004:Hypoglycemic Agents; D007328:Insulin