van den Berghe et al.(11 van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, et al. Intensive insulin therapy in critically ill patients. N Engl J Med. 2001;345(19):1359-67.)
|
Surgical (n = 1548) |
204 (13.2) |
80 - 110 180 - 200 |
103 153 |
Overall (4.6/8.0) (p = 0.04) Without DM (4.7/8.4) With DM (4.0/5.8) |
Lower incidence of bacteremia (4.2% versus 7.8%, p = 0.003); TRR (4.8% versus 8.2%, p = 0.007); PNP (28.7% versus 57.9%, p = 0.001) VM (d) (10 versus 12, p = 0.006) |
van den Berghe et al.(2727 Van den Berghe G, Wilmer A, Hermans G, Meersseman W, Wouters PJ, Milants I, et al. Intensive insulin therapy in the medical ICU. N Engl J Med. 2006;354(5);449-61.)
|
Medical (n = 1200) |
203 (16.9) |
80 - 110 180 - 200 |
111 153 |
Overall (24.2/26.8) (p = 0.31) Without DM (36.8/40.9) With DM (39.6/35.0) |
Shorter MV time (HR 1.21, 95%CI 1.02 - 1.44, p = 0.03); ARF (5.9% versus 8.9%, p = 0.04); Staging in ICU (HR 1.15, 95% CI 1.01-1.32, p = 0.04) |
NICE-SUGAR(44 NICE-SUGAR Study Investigators, Finfer S, Chittock DR, Su SY, Blair D, Foster D, Dhingra V, et al. Intensive versus conventional glucose control in critically ill patients. N Engl J Med. 2009;360(13):1283-97.)
|
Medical-surgical (n = 6104) |
1211 (20.1) |
80 - 108 < 180 |
118 145 |
Overall (27.5/24.9) (p = 0.02) Without DM (26.5/24.2) With DM (31.7/27.7) |
Severe hypoglycemia (6.8% versus 0.5%, p = 0.001) |
Arabi et al.(2828 Arabi YM, Dabbagh OC, Tamim HM, Al-Shimemeri AA, Memish ZA, Haddad SH, et al. Intensive versus conventional insuline therapy: a randomized controlled trial in medical and surgical critically ill patients. Crit Care Med. 2008;36(12):3190-7.)
|
Medical-surgical (n = 523) |
208 (39.8) |
80 - 110 180 - 200 |
115 171 |
Overall (13.5/17.1) (p = 0.70) Without DM (13.8/14.2) With DM (12.9/20.3) |
Hypoglycemia (28.6% versus 3.1%, p = 0.0001) |
De la Rosa et al.(2929 De La Rosa Gdel C, Donado JH, Restrepo AH, Quintero AM, González LG, Saldarriaga NE, Bedoya M, Toro JM, Velásquez JB, Valencia JC, Arango CM, Aleman PH, Vasquez EM, Chavarriaga JC, Yepes A, Pulido W, Cadavid CA; Grupo de Investigacion en Cuidado intensivo: GICI-HPTU. Strict glycaemic control in patients hospitalised in a mixed medical and surgical intensive care unit: a randomised clinical trial. Crit Care. 2008;12(5):R120)
|
Medical-surgical (n = 504) |
61 (12.1) |
80 - 110 180 - 200 |
117 149 |
Overall (36.6/32.4) With DM (37.5/31.0) |
Severe hypoglycemia (8.3% versus 0.8%, p = 0.001) |
Brunkhorst et al.(33 Brunkhorst FM, Engel C, Bloos F, Meier-Hellmann A, Ragaller M, Weiler N, Moerer O, Gruendling M, Oppert M, Grond S, Olthoff D, Jaschinski U, John S, Rossaint R, Welte T, Schaefer M, Kern P, Kuhnt E, Kiehntopf M, Hartog C, Natanson C, Loeffler M, Reinhart K; German Competence Network Sepsis (SepNet). Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med 2008; 358(2):125-39.)
|
Sepsis/septic shock (n = 488) |
163 (30.4) |
80 - 110 180 - 200 |
112 151 |
24.7 versus 26.0 (p = 0.74) |
Severe hypoglycemia (17.0% versus 4.1%, p = 0.001) |
Preiser et al.(22 Preiser JC, Devos P, Ruiz-Santana S, Mélot C, Annane D, Groeneveld J, et al. A prospective randomized multi-centre controlled trial on tight glucose control by intensive insulin therapy in adult intensive care units: the Glucontrol study. Intensive Care Med. 2009;35(10):1738-48.)
|
Medical-surgical (n = 1078) |
203 (18.8) |
80 - 110 140-180 |
118 145 |
17.2 versus 15.3 (p = 0.41) |
Severe hypoglycemia (8.7% versus 2.7%, p = 0.0001) |
Kalfon et al.(3030 Kalfon P, Giraudeau B, Ichai C, Guerrini A, Brechot N, Cinotti R, Dequin PF, Riu-Poulenc B, Montravers P, Annane D, Dupont H, Sorine M, Riou B; CGAO-REA Study Group. Tight computerized versus conventional glucose control in the ICU: a randomized controlled trial. Intensive Care Med. 2014;40(2):171-81.)
|
Medical-surgical (n = 2684) |
536 (20.2) |
80 - 110 < 180 |
115 126 |
32.3 versus 34.1 (p = 0.32) |
Severe hypoglycemia 13.2% versus 6.2%, p = 0.001) |