Intensive insulin therapy in critically ill patients

OBJECTIVE: To observe the effect of intensive insulin therapy on improving the condition of critically ill patients

Bibliographische Detailangaben
Veröffentlicht in:Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue. - 1998. - 18(2006), 12 vom: 14. Dez., Seite 748-50
1. Verfasser: Wang, Ling-cong (VerfasserIn)
Weitere Verfasser: Lei, Shu, Wu, Yan-chun, Wu, Jian-nong, Wang, Lan-fang, Guan, Tian-rong, Jiang, Hui-fang, Ni, Hai-xiang, Ye, Xue-hui
Format: Aufsatz
Sprache:Chinese
Veröffentlicht: 2006
Zugriff auf das übergeordnete Werk:Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue
Schlagworte:English Abstract Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't Hypoglycemic Agents Insulin
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500 |a Citation Status MEDLINE 
520 |a OBJECTIVE: To observe the effect of intensive insulin therapy on improving the condition of critically ill patients 
520 |a METHODS: A prospective, randomized, controlled study involving adults receiving mechanical ventilation was performed. On admission, critically ill patients were randomly assigned to receive intensive insulin therapy (infusion of insulin only if the blood glucose level exceeded 6.1 mmol/L and maintenance of blood glucose at a level 4.4-6.1 mmol/L, IT group) and conventional treatment (infusion of insulin only if the blood glucose level exceeded 11.9 mmol/L and maintenance of blood glucose at a level 10.0-11.1 mmol/L, CT group). The blood glucose was detected every 4 hours. The days of stay in the intensive care unit (ICU), time of the ventilatory support needed, the time for retention of tracheal intubation, the morning blood glucose level (6 am), the intake of nonprotein calories per day, the dosage of required insulin per day,therapeutic intervention scoring system-28 (TISS-28) score,human leukocyte antigen (locus) DR (HLA-DR), CD4+/CD8+, the mortality rate,acute renal failure (serum creatine >221 micromol/L), bilirubinemia (total bilirubin >34.2 micromol/L),the number of patients who received red-cell transfusions,fever (temperature in mouth >38.5 centigrade) and the rate of hypoglycemia were determined and registered 
520 |a RESULTS: In a total of 116 patients enrolled, intensive insulin therapy reduced mortality rate (44.83 % with conventional treatment, compared with 12.07 % with intensive insulin therapy,P< 0.01). Intensive insulin therapy reduced the days of stay in ICU, TISS-28 score per day, time of the ventilatory support needed, time for retention of tracheal intubation, mean morning blood glucose levels (6 am) compared with those in CT group (P<0.05 or P<0.01), and patients receiving intensive insulin therapy were less likely to require intensive care. Intensive insulin therapy also raised consumption of insulin per day, HLA-DR and CD4+/CD8+ obviously (P<0.05 or P<0.01). Compare with the morbidity between two groups, the incidence of fever due to infection, acute renal failure and red-cell transfusions were higher in CT group (all P<0.01) 
520 |a CONCLUSION: Intensive insulin therapy maintaining blood glucose at a level 4.4-6.1 mmol/L reduces mortality rate among critically ill patients 
650 4 |a English Abstract 
650 4 |a Journal Article 
650 4 |a Randomized Controlled Trial 
650 4 |a Research Support, Non-U.S. Gov't 
650 7 |a Hypoglycemic Agents  |2 NLM 
650 7 |a Insulin  |2 NLM 
700 1 |a Lei, Shu  |e verfasserin  |4 aut 
700 1 |a Wu, Yan-chun  |e verfasserin  |4 aut 
700 1 |a Wu, Jian-nong  |e verfasserin  |4 aut 
700 1 |a Wang, Lan-fang  |e verfasserin  |4 aut 
700 1 |a Guan, Tian-rong  |e verfasserin  |4 aut 
700 1 |a Jiang, Hui-fang  |e verfasserin  |4 aut 
700 1 |a Ni, Hai-xiang  |e verfasserin  |4 aut 
700 1 |a Ye, Xue-hui  |e verfasserin  |4 aut 
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