Evidence map›Paper›PMID 42477260›Full record

ReviewNeurocritical care2026

Glycemic Control in Severe Acute Brain Injury: Systematic Review and Meta-analysis with Trial Sequential Analysis.

Anne-Sophie Worm Fenger, Markus Harboe Olsen, Helene Ravnholt Jensen, Signe Janum Eskildsen, Lea Rue Honoré, Maria Louise Fabritius, Daniel Kondziella, Signe Tellerup Nielsen, Rikke Krogh-Madsen, Christian Gunge Riberholt and 1 more

Erratum issuedAbstract readReview
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In one paragraph

Review in Neurocritical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Anne-Sophie Worm FengerDepartment of Neuroanaesthesiology, The Neuroscience Centre, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark. anne-sophie.fenger.03@regionh.dk.ORCID http://orcid.org/0000-0002-6423-4549
Markus Harboe OlsenDepartment of Neuroanaesthesiology, The Neuroscience Centre, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark.
Helene Ravnholt JensenDepartment of Neuroanaesthesiology, The Neuroscience Centre, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark.
Signe Janum EskildsenDepartment of Occupational Therapy and Physiotherapy, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark.
Lea Rue HonoréDepartment of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark.
Maria Louise FabritiusDepartment of Neuroanaesthesiology, The Neuroscience Centre, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark.
Daniel KondziellaDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark.
Signe Tellerup NielsenDepartment of Anaesthesiology and Intensive Care, Herlev and Gentofte Hospital, Herlev, Denmark.
Rikke Krogh-MadsenDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark.
Christian Gunge RiberholtDepartment of Neuroanaesthesiology, The Neuroscience Centre, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark.
Kirsten MøllerDepartment of Neuroanaesthesiology, The Neuroscience Centre, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark.

Funding

Novo Nordisk Fonden NNF20OC0065750
6 · The paper itself

Abstract

backgroundHyperglycemia is common in intensive care unit (ICU) patients, including those with acute brain injury. Although many studies associate hyperglycemia with increased mortality, the optimal blood glucose target remains uncertain. This systematic review compares strict versus liberal glycemic control in ICU patients with acute brain injury, focusing on all-cause mortality, neurological outcome, and health-related quality of life.

methodsTwo authors independently searched CENTRAL, EMBASE, Medline, Web of Science, CINAHL, and trial registers for studies comparing glycemic control targets. Data were extracted in duplicate with discrepancies resolved by two screeners using Covidence. We performed meta-analysis, trial sequential analysis (TSA), and risk-of-bias assessment, and evaluated certainty of evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE).

resultsFrom 29,221 records, we included 18 randomized clinical trials (RCTs) (N = 3196 patients) and 13 observational studies (N = 8354 patients). Fixed-effect meta-analysis suggested no effect on mortality from strict compared with liberal control (N = 3196 patients; RR 0.95; 95% CI 0.84-1.08; I

conclusionsLow to very low certainty evidence suggests there is no difference between strict and liberal glycemic control regarding mortality or functional neurological outcome after severe acute brain injury. While additional large, low-bias RCTs could improve certainty, the benefit from strict glycemic control remains uncertain.

Indexed as

Blood glucoseBrain injuriesCritical careGlycemic controlHyperglycemiaHypoglycemiaIntensive care unitsIntracranial hemorrhagesSubarachnoid hemorrhageTraumatic brain injuries

Identifiers

PMID42477260

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.