title: Effect of blood-sugar limitation on intensive care mortality: Intragroup evaluation.
abstract: OBJECTIVE
  To evaluate the safety profile of blood sugar limits in intensive care unit (ICU) patients.
  
  
  METHODS
  Adult patients with ICU stay >36 h, more than two blood sugar measurements and antibiotic therapy concordant with locally adapted guidelines were included. For analyses, one study cohort was defined in two ways: as a narrow group, euglycaemic patients' blood sugar levels 80-150 mg/dl; as a moderate group, euglycaemic patients' blood sugar levels 80-180 mg/dl. Dysglycaemia was defined as blood sugar levels <80 mg/dl for >5% of measurements, and >150 mg/dl or >180 mg/dl (narrow or moderate groups, respectively) for >10% of measurements. The primary endpoint was ICU mortality (euglycaemia versus dysglycaemia).
  
  
  RESULTS
  The study comprised 668 patients. When defined as a narrow group, ICU mortality was 3% (four of 135) euglycaemic versus 10% (54/533) dysglycaemic patients (odds ratio [OR] 3.692, 95% confidence interval [CI] 1.313, 10.382). When defined as a moderate group, ICU mortality was 6% (21/351) euglycaemic versus 12% (37/317) dysglycaemic patients (OR 2.077, 95% CI 1.188, 3.630). Frequency of severe hypoglycaemia (blood sugar <40 mg/dl) was not different between the narrow and moderate euglycaemic ranges.
  
  
  CONCLUSIONS
  Euglycaemia was associated with lower ICU mortality than dysglycaemia, and incidence of hypoglycaemia was low overall in this study. Based on current published evidence, therapeutic targets should be defined according to individual patient characteristics.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Irit
authors.initials: I
authors.lastname: Nachtigall
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Sascha
authors.initials: S
authors.lastname: Tafelski
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Andrey
authors.initials: A
authors.lastname: Tamarkin
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Rothbart
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Lange
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Wegener
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Balzer
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Jack Poul Luengas
authors.initials: JP
authors.lastname: Burgos
authors.affiliation: Institute of Medical Biometry, Charité - Universitätsmedizin Berlin and SOSTANA GmbH, Berlin, Germany.
authors.forename: Klaus-Dieter
authors.initials: KD
authors.lastname: Wernecke
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany claudia.spies@charite.de.
authors.forename: Claudia
authors.initials: C
authors.lastname: Spies
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D003141:Communicable Diseases / Q000209:etiology; D003422:Critical Care / Q000706:statistics & numerical data*; D003710:Demography; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012121:Respiration, Artificial; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose
keywords: Hyperglycaemia; hypoglycaemia; intensive care unit; mortality; standard operating procedures