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See detailContinuous glucose control in the ICU: report of a 2013 round table meeting.
Wernerman, Jan; Desaive, Thomas ULg; Finfer, Simon et al

in Critical care (London, England) (2014), 18(3), 226

Achieving adequate glucose control in critically ill patients is a complex but important part of optimal patient management. Until relatively recently, intermittent measurements of blood glucose have been ... [more ▼]

Achieving adequate glucose control in critically ill patients is a complex but important part of optimal patient management. Until relatively recently, intermittent measurements of blood glucose have been the only means of monitoring blood glucose levels. With growing interest in the possible beneficial effects of continuous over intermittent monitoring and the development of several continuous glucose monitoring (CGM) systems, a round table conference was convened to discuss and, where possible, reach consensus on the various aspects related to glucose monitoring and management using these systems. In this report, we discuss the advantages and limitations of the different types of devices available, the potential advantages of continuous over intermittent testing, the relative importance of trend and point accuracy, the standards necessary for reporting results in clinical trials and for recognition by official bodies, and the changes that may be needed in current glucose management protocols as a result of a move towards increased use of CGM. We close with a list of the research priorities in this field, which will be necessary if CGM is to become a routine part of daily practice in the management of critically ill patients. [less ▲]

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See detailRestoring Normoglycaemia: Not So Harmless
Preiser, Jean-Charles ULg

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 ▲]

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See detailIs it time for implementation of tight glycaemia control by intensive insulin therapy in every ICU?
Devos, P.; Preiser, Jean-Charles ULg

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 ▲]

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See detailTight blood glucose control: a recommendation applicable to any critically ill patient?
Devos, P.; Preiser, Jean-Charles ULg

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 ▲]

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