ReviewCritical care (London, England)2010
Clinical review: Strict or loose glycemic control in critically ill patients--implementing best available evidence from randomized controlled trials.
Review in Critical care (London, England), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 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
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Glucose prediction by analysis of exhaled metabolites - a systematic review.BMC anesthesiology · 2014Pooled it
- Clinical practice guidelines for nutritional assessment and monitoring of adult ICU patients in China.Journal of intensive medicine · 2024Article
- Nutritional support and prevention of post-intensive care syndrome: the Italian SIAARTI survey.Journal of anesthesia, analgesia and critical care · 2023Article
- Advances in safe insulin infusions.Drugs in context · 2021Review
- Increased insulin resistance in intensive care: longitudinal retrospective analysis of glycaemic control patients in a New Zealand ICU.Therapeutic advances in endocrinology and metabolism · 2021Article
- Continuous glucose monitoring in the ICU: clinical considerations and consensus.Critical care (London, England) · 2017Review
- Untangling glycaemia and mortality in critical care.Critical care (London, England) · 2017Article
- Manual versus Automated moNitoring Accuracy of GlucosE II (MANAGE II).Critical care (London, England) · 2016Article
- Glycemic control: please agree to disagree.Intensive care medicine · 2016Article
- Diabetes and the Association of Postoperative Hyperglycemia With Clinical and Economic Outcomes in Cardiac Surgery.Diabetes care · 2016Article
- Associations between bolus infusion of hydrocortisone, glycemic variability and insulin infusion rate variability in critically Ill patients under moderate glycemic control.Annals of intensive care · 2015Article
- Hypocaloric enteral nutrition protects against hypoglycemia associated with intensive insulin therapy better than intravenous dextrose.The American surgeon · 2014Article
- Accuracy and limitations of continuous glucose monitoring using spectroscopy in critically ill patients.Annals of intensive care · 2014Article
- Glycemic control in pediatric patients on extracorporeal membrane oxygenation.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2013Article
- Mild hypoglycemia is strongly associated with increased intensive care unit length of stay.Annals of intensive care · 2011Article
- Finding the sweet spot: identification of optimal glucose levels in critically injured patients.The Journal of trauma · 2011Article
- Provision of balanced nutrition protects against hypoglycemia in the critically ill surgical patient.JPEN. Journal of parenteral and enteral nutrition · 2011Article
- Increasing blood glucose variability heralds hypoglycemia in the critically ill.The Journal of surgical research · 2011Article
- Mild hypoglycemia is independently associated with increased mortality in the critically ill.Critical care (London, England) · 2011Article
- Is critical illness neuromyopathy and duration of mechanical ventilation decreased by strict glucose control?Neurocritical care · 2011Review
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.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Glycemic control aiming at normoglycemia, frequently referred to as 'strict glycemic control' (SGC), decreased mortality and morbidity of adult critically ill patients in two randomized controlled trials (RCTs). Five successive RCTs, however, failed to show benefit of SGC with one trial even reporting an unexpected higher mortality. Consequently, enthusiasm for the implementation of SGC has declined, hampering translation of SGC into daily ICU practice. In this manuscript we attempt to explain the variances in outcomes of the RCTs of SGC, and point out other limitations of the current literature on glycemic control in ICU patients. There are several alternative explanations for why the five negative RCTs showed no beneficial effects of SGC, apart from the possibility that SGC may indeed not benefit ICU patients. These include, but are not restricted to, variability in the performance of SGC, differences among trial designs, changes in standard of care, differences in timing (that is, initiation) of SGC, and the convergence between the intervention groups and control groups with respect to achieved blood glucose levels in the successive RCTs. Additional factors that may hamper translation of SGC into daily ICU practice include the feared risk of severe hypoglycemia, additional labor associated with SGC, and uncertainties about who the primarily responsible caregiver should be for the implementation of SGC.
Indexed as
Identifiers
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.