  Restoring Normoglycaemia: Not So HarmlessPreiser, Jean-Charles  in Critical Care (London, England) (2008), 12(1), 116 ABSTRACT: Three independent studies of tight glucose control were recently stopped prematurely due to an excess mortality in the intensive treatment arm. This commentary briefly discusses the potential ... [more ▼] ABSTRACT: Three independent studies of tight glucose control were recently stopped prematurely due to an excess mortality in the intensive treatment arm. This commentary briefly discusses the potential mechanisms and reminds the potential benefits of physiological stress hyperglycemia. [less ▲] Detailed reference viewed: 5 (0 ULg)Is it time for implementation of tight glycaemia control by intensive insulin therapy in every ICU?; Preiser, Jean-Charles in Critical Care (London, England) (2006), 10(2), 130 The second study on tight glycaemia control by intensive insulin therapy (IIT) confirmed in medical intensive care unit patients the decrease in hospital mortality reported by the same team in the first ... [more ▼] The second study on tight glycaemia control by intensive insulin therapy (IIT) confirmed in medical intensive care unit patients the decrease in hospital mortality reported by the same team in the first IIT trial in surgical patients. However, methodological concerns, the high rate of hypoglycaemia in spite of the infusion of large doses of parenteral glucose and the frequent use of steroids presently preclude considering these results as recommendations in other intensive care units, but rather argue for the need for large-scale assessment of the IIT approach by multi-centre studies to confirm the efficacy and safety of this therapeutic modality. [less ▲] Detailed reference viewed: 7 (0 ULg)Tight blood glucose control: a recommendation applicable to any critically ill patient?; Preiser, Jean-Charles in Critical Care (London, England) (2004), 8(6), 427-429 The issue of tight glucose control with intensive insulin therapy in critically ill patients remains controversial. Although compelling evidence supports this strategy in postoperative patients who have ... [more ▼] The issue of tight glucose control with intensive insulin therapy in critically ill patients remains controversial. Although compelling evidence supports this strategy in postoperative patients who have undergone cardiac surgery, the use of tight glucose control has been challenged in other situations, including in medical critically ill patients and in those who have undergone non-cardiac surgery. Similarly, the mechanisms that underlie the effects of high-dose insulin are not fully elucidated. These arguments emphasize the need to study the effects of tight glucose control in a large heterogeneous cohort of intensive care unit patients. [less ▲] Detailed reference viewed: 9 (0 ULg) |
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