ArticleAnnals of surgery2004
Insulin treatment improves the systemic inflammatory reaction to severe trauma.
Article in Annals of surgery, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 72 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
72 citing papers in PubMed, 1 synthesis or guideline pooled it, 230 citations in OpenAlex.
- Metabolic implications of severe burn injuries and their management: a systematic review of the literature.World journal of surgery · 2008Pooled it
- [A prospectively randomized controlled study of the effects of intensive insulin therapy combined with glutamine on nutritional metabolism, inflammatory response, and hemodynamics in severe burn patients].Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns · 2021Trial
- Glucose Control in Severely Burned Patients Using Metformin: An Interim Safety and Efficacy Analysis of a Phase II Randomized Controlled Trial.Annals of surgery · 2016Trial
- Moderate glucose control results in less negative nitrogen balances in medical intensive care unit patients: a randomized, controlled study.Critical care (London, England) · 2012Trial
- Insulin suppresses endotoxin-induced oxidative, nitrosative, and inflammatory stress in humans.Diabetes care · 2010Trial
- Intensive insulin therapy in severely burned pediatric patients: a prospective randomized trial.American journal of respiratory and critical care medicine · 2010Trial
- Randomized controlled trial to determine the efficacy of long-term growth hormone treatment in severely burned children.Annals of surgery · 2009Trial
- Pathophysiologic response to severe burn injury.Annals of surgery · 2008Trial
- Article
- Metformin administration improves adverse outcomes in older adult burn patients: a single-centre cohort study.npj aging · 2025Article
- Endocrine and metabolic alterations in response to systemic inflammation and sepsis: a review article.Molecular medicine (Cambridge, Mass.) · 2025Review
- Protective effects of insulin treatment in the morphological alterations and oxidative damage to DNA in the liver of young rats subjected to skin scald burn injury.International journal of burns and trauma · 2025Article
- Metformin is associated with reduced risk of mortality and morbidity in burn patients compared to insulin.Burns : journal of the International Society for Burn Injuries · 2024Article
- Elevated Hemoglobin A1c and the Risk of Developing ARDS in Two Cohort Studies.CHEST critical care · 2024Article
- Metabolic response to burn injury: a comprehensive bibliometric study.Frontiers in medicine · 2024Article
- The Role of the Insulin/Glucose Ratio in the Regulation of Pathogen Biofilm Formation.Biology · 2023Article
- An Overview of Recent Developments in the Management of Burn Injuries.International journal of molecular sciences · 2023Review
- Review
- Evidence showing lipotoxicity worsens outcomes in covid-19 patients and insights about the underlying mechanisms.iScience · 2022Article
- Obesity-Mediated Immune Modulation: One Step Forward, (Th)2 Steps Back.Frontiers in immunology · 2022Review
12 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveDetermine the effect of insulin on the systemic inflammatory response, pro- and anti-inflammatory cytokines and hepatic acute-phase-response in severely burned pediatric patients. SUMMARY BACKGROUND DATA: The systemic inflammatory and hepatic acute-phase-response contribute to hypermetabolism, multi-organ failure, and mortality. Insulin has been recently shown to decrease mortality and to prevent the incidence of multi-organ failure in critically ill patients; however, the underlying mechanisms have not been defined.
methodsThirteen thermally injured children received insulin to maintain blood glucose at a range from 120 to 180 mg/dl, 15 children received no insulin with blood glucose levels also at range from 120 to 180 mg/dl and served as controls. Our outcome measures encompassed the effect of insulin on pro-inflammatory mediators, the hepatic acute-phase-response, fat, and the IGF-I system.
resultsInsulin administration decreased pro-inflammatory cytokines and proteins, while increasing constitutive-hepatic proteins (P < 0.05). Burned children receiving insulin required significantly less albumin substitution to maintain normal levels compared with control (P < 0.05). Insulin decreased free fatty acids and serum triglycerides when compared with controls (P < 0.05). Serum IGF-I and IGFBP-3 significantly increased with insulin administration (P < 0.05).
conclusionInsulin attenuates the inflammatory response by decreasing the pro-inflammatory and increasing the anti-inflammatory cascade, thus restoring systemic homeostasis, which has been shown critical for organ function and survival in critically ill patients.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.