ArticleIntensive care medicine2007
Failure to achieve glycemic control despite intensive insulin therapy in a medical ICU: incidence and influence on ICU mortality.
Article in Intensive care medicine, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 49 citations in OpenAlex.
- Implementing glucose control in intensive care: a multicenter trial using statistical process control.Intensive care medicine · 2010Trial
- Tight glycaemic control by an automated algorithm with time-variant sampling in medical ICU patients.Intensive care medicine · 2008Trial
- Glycemic targets in critically ill adults: A mini-review.World journal of diabetes · 2021Review
- Article
- Random plasma glucose values measured in community dental practices: findings from the Dental Practice-Based Research Network.Clinical oral investigations · 2013Article
- The glucogram: A new quantitative tool for glycemic analysis in the surgical intensive care unit.International journal of critical illness and injury science · 2011Article
- Organ dysfunction is associated with hyperglycemia in critically ill children.Intensive care medicine · 2010Article
- International recommendations for glucose control in adult non diabetic critically ill patients.Critical care (London, England) · 2010Article
- Pilot evaluation of a prototype critical care blood glucose monitor in normal volunteers.Journal of diabetes science and technology · 2009Article
- Perioperative intensive insulin therapy using artificial endocrine pancreas in patients undergoing pancreatectomy.World journal of gastroenterology · 2009Review
- Impact of shock requiring norepinephrine on the accuracy and reliability of subcutaneous continuous glucose monitoring.Intensive care medicine · 2009Article
- Admission blood glucose is an independent predictive factor for hospital mortality in polytraumatised patients.Intensive care medicine · 2009Article
- Characterization of persistent hyperglycemia: what does it mean postinjury?The Journal of trauma · 2009Article
- Why are clinicians not embracing the results from pivotal clinical trials in severe sepsis? A bayesian analysis.PloS one · 2008Article
- Year in review in Intensive Care Medicine, 2007. I. Experimental studies. Clinical studies: brain injury and neurology, renal failure and endocrinology.Intensive care medicine · 2008Review
- Intensive insulin therapy and mortality in critically ill patients.Critical care (London, England) · 2008Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveIntensive insulin therapy reduces mortality in subgroups of intensive care unit (ICU) patients, and awareness of the importance of blood glucose level (BGL) control has increased among ICU physicians and nurses. The impact of insulin treatment strategies on mortality may be influenced by their efficacy in achieving the target BGL range. We assessed the efficacy of an insulin treatment strategy in maintaining BGL within the target range, and we compared ICU mortality in patients who did and did not reach the BGL target.
designProspective cohort study.
setting12-bed medical ICU in a tertiary teaching hospital. PATIENTS AND
participantsAdults consecutively admitted over a 9-month period to an ICU where standard care included an insulin treatment strategy aimed at maintaining BGL<or=7 mmol/l. MEASUREMENTS AND MAIN
results105 patients were included. Median SAPS II was 45 (31-54). Failure to control BGL (mean capillary BGL >7 mmol/l after initial hyperglycemia correction) occurred in 32 patients (31.1%) and was associated with a significant increase in ICU mortality (56.2 vs. 23.3% in patients with successful BGL control). In the multivariate analysis, failure to control BGL independently predicted death in the ICU (OR 5.9, 2.1-16.6, p<0.001).
conclusionsFailure to control BGL despite intensive insulin therapy was common and independently associated with ICU mortality. Failure to control BGL may considerably affect the overall impact of insulin treatment strategies on mortality.
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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.