More Doubts About Tight Glycemic Control in the ICU

ICU mortality was not lessened by low blood glucose targets, and some evidence suggests that brain metabolism in brain-injured patients might be affected adversely by low glucose targets.

The latest study on intensive insulin therapy in the intensive care unit comes from a university hospital in Saudi Arabia. In this randomized trial, 523 patients in a mixed medical-surgical ICU received either intensive insulin therapy (blood glucose target, 80–110 mg/dL) or conventional insulin therapy (blood glucose target, 180–200 mg/dL, for patients whose glucose levels exceeded 200 mg/dL). The primary endpoint — ICU mortality — did not differ significantly in the two groups. However, hypoglycemia (defined as blood glucose <40 mg/dL) occurred much more often in the intensive group than in the conventional group (29% vs. 3%).

In another recent study — conducted in the neurology ICU at Columbia University — researchers examined the relatio…

Reviewing Author

Allan S. Brett, MD

Disclosures

Nothing to disclose

Allan S. Brett, MD

Disclosures

Nothing to disclose