Trial reportIntensive care medicine2008
Early versus late intravenous insulin administration in critically ill patients.
Trial report in Intensive care medicine, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 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
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Propensity scores in intensive care and anaesthesiology literature: a systematic review.Intensive care medicine · 2010Pooled it
- Early versus late intravenous insulin administration in critically ill patients.Intensive care medicine · 2008Trial
- Insulin therapy and blood glucose management in critically ill patients: a 1-day cross-sectional observational study in 69 French intensive care units.Annals of intensive care · 2023Article
- Glycemic control of type 2 diabetic patients with coronavirus disease during hospitalization: a proposal for early insulin therapy.American journal of physiology. Endocrinology and metabolism · 2020Article
- Article
- Organ dysfunction is associated with hyperglycemia in critically ill children.Intensive care medicine · 2010Article
- Diabetes, insulin, and development of acute lung injury.Critical care medicine · 2009Review
- Impact of shock requiring norepinephrine on the accuracy and reliability of subcutaneous continuous glucose monitoring.Intensive care medicine · 2009Article
- Diabetes mellitus is an independent risk factor for ICU-acquired bloodstream infections.Intensive care medicine · 2009Article
- Year in review in Intensive Care Medicine, 2008: I. Brain injury and neurology, renal failure and endocrinology, metabolism and nutrition, sepsis, infections and pneumonia.Intensive care medicine · 2009Review
- Interactions between antihyperglycemic drugs and the renin-angiotensin system: Putative roles in COVID-19. A mini-review.Diabetes & metabolic syndromeReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
objectiveTo investigate whether timing of intensive insulin therapy (IIT) after intensive care unit (ICU) admission influences outcome. DESIGN AND
settingSingle-center prospective cohort study in the 14-bed medical ICU of a 1,171-bed tertiary teaching hospital. PATIENTS: The study included 127 patients started on ITT within 48 h of ICU admission (early group) and 51 started on ITT thereafter (late group); the groups did not differ in age, gender, race, BMI, APACHE III, ICU steroid use, admission diagnosis, or underlying comorbidities. MEASUREMENTS AND
resultsThe early group had more ventilator-free days in the first 28 days after ICU admission (median 12 days, IQR 0-24, vs. 1 day, 0-11), shorter ICU stay (6 days, IQR 3-11, vs. 11 days, vs. 7-17), shorter hospital stay (15 days, IQR 9-30, vs. 25 days, 13-43), lower ICU mortality (OR 0.48), and lower hospital mortality (OR 0.27). On multivariate analysis, early therapy was still associated with decreased hospital mortality (ORadj 0.29). The strength and direction of association favoring early IIT was consistent after propensity score modeling regardless of method used for analysis.
conclusionsEarly IIT was associated with better outcomes. Our results raise questions about the assumption that delayed administration of IIT has the same benefit as early therapy. A randomized study is needed to determine the optimal timing of therapy.
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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.