Journal of Critical Care
Volume 24, Issue 3 , Pages 371-378 , September 2009

A randomized controlled trial comparing a computer-assisted insulin infusion protocol with a strict and a conventional protocol for glucose control in critically ill patients

  • Alexandre B. Cavalcanti, MD

      Affiliations

    • Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo 05652-000, Brazil
    • Intensive Care Unit, Hospital Estadual Mário Covas, Santo André 09190-615, Brazil
    • Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-903, Brazil
    • Corresponding Author InformationCorresponding author. Hospital Albert Einstein—CTI-Adultos, 05651-901 São Paulo, Brazil. Tel.: +55 11 98829343; fax: +55 11 35547083.
    • ,
  • Eliezer Silva, PhD

      Affiliations

    • Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo 05652-000, Brazil
    • ,
  • Adriano J. Pereira, MD

      Affiliations

    • Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo 05652-000, Brazil
    • ,
  • Milton Caldeira-Filho, MD

      Affiliations

    • Intensive Care Unit, Hospital Dona Helena, Joinville 89204-250, Brazil
    • ,
  • Francisca P. Almeida, RN

      Affiliations

    • Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo 05652-000, Brazil
    • ,
  • Glauco A. Westphal, MD

      Affiliations

    • Intensive Care Unit, Centro Hospitalar UNIMED, Joinville 89204-060, Brazil
    • ,
  • Renate Beims, RN

      Affiliations

    • Intensive Care Unit, Hospital Municipal São José, Joinville 89202-000, Brazil
    • ,
  • Caio C. Fernandes, MD

      Affiliations

    • Intensive Care Unit, Hospital Estadual Mário Covas, Santo André 09190-615, Brazil
    • ,
  • Thiago D. Correa, MD

      Affiliations

    • Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo 05652-000, Brazil
    • ,
  • Marcos R. Gouvea, BCS

      Affiliations

    • Education and Research Institute—Hospital Israelita Albert Einstein, São Paulo, 05652-000, Brazil
    • ,
  • José Eluf-Neto, PhD

      Affiliations

    • Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-903, Brazil

References 

  1. Van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in the critically ill patients. N Engl J Med. 2001;345:1359–1367
  2. Brunkhorst FM, Engel C, Bloos F, et al. Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med. 2008;358:125–139
  3. Preiser JC. Intensive glycemic control in med-surg patients (European Glucontrol trial). In: Society of Critical Care Medicine's 36th Critical Care Congress. 2007;
  4. Finfer S, Chittock DR, Su SY, et al. Intensive versus conventional glucose control in critically ill patients. N Engl J Med. 2009;360:1283–1297
  5. Van den Berghe G, Wilmer A, Hermans G, et al. Intensive insulin therapy in the medical ICU. N Engl J Med. 2006;354:449–461
  6. American College of Endocrinology and American Diabetes Association consensus statement on inpatient diabetes and glycemic control. Endocr Pract. 2006;12:458–468
  7. Dellinger RP, Carlet JM, Masur H, et al. Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock. Intensive Care Med. 2004;30:536–555
  8. Krinsley JS, Grover A. Severe hypoglycemia in critically ill patients: risk factors and outcomes. Crit Care Med. 2007;35:2262–2267
  9. Meijering S, Corstjens AM, Tulleken JE, et al. Towards a feasible algorithm for tight glycaemic control in critically ill patients: a systematic review of the literature. Crit Care. 2006;10:R19
  10. Pachler C, Plank J, Weinhandl H, et al. Tight glycaemic control by an automated algorithm with time-variant sampling in medical ICU patients. Intensive Care Med. 2008;34:1224–1230
  11. Plank J, Blaha J, Cordingley J, et al. Multicentric, randomized, controlled trial to evaluate blood glucose control by the model predictive control algorithm versus routine glucose management protocols in intensive care unit patients. Diabetes Care. 2006;29:271–276
  12. Vogelzang M, van der Horst I, Nijsten MW. Hyperglycaemic index as a tool to assess glucose control: a retrospective study. Crit Care. 2004;8:R122–R127
  13. Finney SJ, Zekveld C, Elia A, et al. Glucose control and mortality in critically ill patients. JAMA. 2003;290:2041–2047
  14. Knaus WA, Draper EA, Wagner DP, et al. APACHE II: a severity of disease classification system. Crit Care Med. 1985;13:818–829
  15. Vincent JL, Moreno R, Takala J, et al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med. 1996;22:707–710
  16. Matthews JN, Altman DG, Campbell MJ, et al. Analysis of serial measurements in medical research. BMJ. 1990;300:230–235
  17. Finkielman JD, Oyen LJ, Afessa B. Agreement between bedside blood and plasma glucose measurement in the ICU setting. Chest. 2005;127:1749–1751
  18. Kanji S, Buffie J, Hutton B, et al. Reliability of point-of-care testing for glucose measurement in critically ill adults. Crit Care Med. 2005;33:2778–2785
  19. Pereira AJ, Cavalcanti AB, Correa TD, et al. Reliability of arterial, capillary and venous point-of-care glucose measurements in the intensive care unit setting: evaluation of two glucometers. Crit Care. 2007;11:s56;[abstr]
  20. Cheung NW, Wong VW, McLean M. The hyperglycemia: intensive insulin infusion in infarction (HI-5) study—a randomized controlled trial of insulin infusion therapy for myocardial infarction. Diabetes Care. 2006;29:765–770
  21. Devos P, Preiser JC. Current controversies around tight glucose control in critically ill patients. Curr Opin Clin Nutr Metab Care. 2007;10:206–209
  22. Vriesendorp TM, van Santen S, de Vries JH, et al. Predisposing factors for hypoglycemia in the intensive care unit. Crit Care Med. 2006;34:96–101

PII: S0883-9441(09)00115-4

doi: 10.1016/j.jcrc.2009.05.005

Journal of Critical Care
Volume 24, Issue 3 , Pages 371-378 , September 2009

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