Role of intravenous insulin therapy in critically ill patients.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
Greet Van den Berghe

Abstract

To summarize the novel evidence for maintaining normoglycemia with intensive insulin therapy during intensive care in critically ill patients, with or without diabetes, in the surgical intensive-care unit. Although the association between hyperglycemia and adverse outcomes of trauma or surgical procedures necessitating intensive care was known, only one intervention study has investigated the causality of this association. This study showed that tight blood glucose control with insulin, aiming for strict normoglycemia (80 to 110 mg/dL or 4.5 to 6.1 mmol/L) during intensive care, dramatically decreased morbidity and mortality. The clinical benefits were present whether or not patients had previously diagnosed diabetes, and they seemed independent of severity and type of critical illness. Multivariate logistic regression analysis indicated that metabolic control, rather than insulin dose per se, statistically explains the beneficial effects of intensive insulin therapy on outcomes of critical illness. Other metabolic effects besides blood glucose control, however, such as normalization of dyslipidemia, and immunologic effects, such as suppression of excessive inflammation and improvement of macrophage function, accompany glycemic...Continue Reading

References

Jan 17, 2002·The New England Journal of Medicine·G van den BergheR Bouillon
May 17, 2002·The New England Journal of Medicine·Irl B Hirsch, Andrea Coviello
Dec 6, 2002·The Journal of Clinical Endocrinology and Metabolism·Dieter MesottenGreet Van Den Berghe
Feb 11, 2003·Critical Care Medicine·Greet Van den BerghePeter Lauwers
Mar 12, 2003·The Journal of Clinical Endocrinology and Metabolism·Troels Krarup HansenGreet Van den Berghe
Oct 16, 2003·JAMA : the Journal of the American Medical Association·Simon J FinneyTimothy W Evans
Jan 13, 2004·The Journal of Clinical Endocrinology and Metabolism·Dieter MesottenGreet Van den Berghe

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Citations

Mar 19, 2008·Cardiovascular Drugs and Therapy·Paresh DandonaPriya Mohanty
Oct 6, 2004·Current Diabetes Reports·Andrew J Ahmann
Dec 24, 2005·Critical Care Medicine·Kees H Polderman, Armand R J Girbes
May 15, 2007·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Jerry J Zimmerman
Aug 19, 2007·Shock·Joseph CuschieriRonald V Maier
Feb 27, 2007·Vascular Health and Risk Management·Anthony H Barnett
Mar 2, 2006·Pituitary·C GaunaA J van der Lely
Oct 1, 2011·Diabetes & Metabolic Syndrome·Shalbha TiwariSurya K Singh
Jun 23, 2007·The Journal of Surgical Research·Mareike LefflerMarc G Jeschke
Aug 2, 2007·The American Journal of Cardiology·Paresh DandonaPriya Mohanty
Mar 31, 2007·Seminars in Thoracic and Cardiovascular Surgery·Paresh DandonaPriya Mohanty
Dec 5, 2006·Diabetes Research and Clinical Practice·Ivan GornikVladimir Gasparović
Feb 20, 2007·The American Journal of Cardiology·Paresh DandonaPriya Mohanty
Feb 10, 2006·Pharmacotherapy·Kevin E Anger, Paul M Szumita
Jan 13, 2005·The Journal of Pediatrics·Roberto Izquierdo
Feb 21, 2009·Journal of the American College of Cardiology·Antonio CerielloRoberto Testa
Oct 30, 2016·Shock·Silvia C TrevelinFernando Q Cunha
Sep 7, 2007·Journal of Cardiac Surgery·Anika BacksterAlden H Harken
Sep 2, 2006·Journal of Intensive Care Medicine·Vidula Vachharajani, Shantel Vital
Sep 10, 2009·Clinical Trials : Journal of the Society for Clinical Trials·Richard DuttonUNKNOWN CONTROL Steering Committee
Jun 30, 2011·European Journal of Anaesthesiology·Ian SmithUNKNOWN European Society of Anaesthesiology
Jun 15, 2007·Current Opinion in Clinical Nutrition and Metabolic Care·Paresh DandonaHusam Ghanim
Jun 6, 2009·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Swati Arora, Murray B Gordon
Jun 24, 2020·Khirurgiia·I N PasechnikK M Markelov
Sep 14, 2012·The Cochrane Database of Systematic Reviews·Ana Maria BuchleitnerDidac Mauricio
Sep 11, 2020·Critical Care Research and Practice·Thanaphruet Issarawattana, Rungsun Bhurayanontachai

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