Trial reportCritical care (London, England)2014
Effects of tight computerized glucose control on neurological outcome in severely brain injured patients: a multicenter sub-group analysis of the randomized-controlled open-label CGAO-REA study.
Trial report in Critical care (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01002482 (Impact of the Use of a Computerized Protocol for Glucose Control Named CGAOtm on the Outcome of Critically Ill Patients), which is not on this map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
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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.
Impact of the Use of a Computerized Protocol for Glucose Control Named CGAOtm on the Outcome of Critically Ill Patients
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Glycaemic control targets after traumatic brain injury: a systematic review and meta-analysis.Critical care (London, England) · 2018Pooled it
- Intensive versus conventional glucose control in critically ill patients with traumatic brain injury: long-term follow-up of a subgroup of patients from the NICE-SUGAR study.Intensive care medicine · 2015Trial
- Severe and multiple hypoglycemic episodes are associated with increased risk of death in ICU patients.Critical care (London, England) · 2015Trial
- Glycemic Control in Severe Acute Brain Injury: Systematic Review and Meta-analysis with Trial Sequential Analysis.Neurocritical care · 2026Review
- Perioperative glycaemic control for people with diabetes undergoing surgery.The Cochrane database of systematic reviews · 2023Review
- Kidney Dysfunction After Traumatic Brain Injury: Pathophysiology and General Management.Neurocritical care · 2023Review
- Expert consensus on the glycemic management of critically ill patients.Journal of intensive medicine · 2022Article
- Glycemic Variability: An Independent Predictor of Mortality and the Impact of Age in Pediatric Intensive Care Unit.Frontiers in pediatrics · 2020Article
- Effects of perioperative tight glycemic control on postoperative outcomes: a meta-analysis.Endocrine connections · 2018Review
- Variation in general supportive and preventive intensive care management of traumatic brain injury: a survey in 66 neurotrauma centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study.Critical care (London, England) · 2018Article
- Stress-Induced Hyperglycemia in Diabetes: A Cross-Sectional Analysis to Explore the Definition Based on the Trauma Registry Data.International journal of environmental research and public health · 2017Article
- Targeted treatment in severe traumatic brain injury in the age of precision medicine.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2017Review
- Continuous glucose monitoring in the ICU: clinical considerations and consensus.Critical care (London, England) · 2017Review
- Glucose Control in the ICU: A Continuing Story.Journal of diabetes science and technology · 2016Review
- Glucose administration after traumatic brain injury exerts some benefits and no adverse effects on behavioral and histological outcomes.Brain research · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionHyperglycemia is a marker of poor prognosis in severe brain injuries. There is currently little data regarding the effects of intensive insulin therapy (IIT) on neurological recovery.
methodsA sub-group analysis of the randomized-controlled CGAO-REA study (NCT01002482) in surgical intensive care units (ICU) of two university hospitals. Patients with severe brain injury, with an expected ICU length of stay ≥ 48 hours were included. Patients were randomized between a conventional glucose management group (blood glucose target between 5.5 and 9 mmol.L(-1)) and an IIT group (blood glucose target between 4.4 and 6 mmol.L(-1)). The primary outcome was the day-90 neurological outcome evaluated with the Glasgow outcome scale.
resultsA total of 188 patients were included in this analysis. In total 98 (52%) patients were randomized in the control group and 90 (48%) in the IIT group. The mean Glasgow coma score at baseline was 7 (± 4). Patients in the IIT group received more insulin (130 (68 to 251) IU versus 74 (13 to 165) IU in the control group, P = 0.01), had a significantly lower morning blood glucose level (5.9 (5.1 to 6.7) mmol.L(-1) versus 6.5 (5.6 to 7.2) mmol.L(-1), P <0.001) in the first 5 days after ICU admission. The IIT group experienced more episodes of hypoglycemia (P < 0.0001). In the IIT group 24 (26.6%) patients had a favorable neurological outcome (good recovery or moderate disability) compared to 31 (31.6%) in the control group (P = 0.4). There were no differences in day-28 mortality. The occurrence of hypoglycemia did not influence the outcome.
conclusionsIn this sub-group analysis of a large multicenter randomized trial, IIT did not appear to alter the day-90 neurological outcome or ICU morbidity in severe brain injured patients or ICU morbidity.
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