tailieunhanh - Báo cáo y học: " Recently published papers: A series of negative results"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Recently published papers: A series of negative results. | Available online http content 13 1 119 Commentary Recently published papers A series of negative results Robert Galloway and Richard Venn Department of Critical Care Worthing Hospital Worthing West Sussex BN11 2DH UK Corresponding author Robert Galloway drrobgalloway@ Published 19 February 2009 This article is online at http content 13 1 119 2009 BioMed Central Ltd Critical Care 2009 13 119 doi cc7708 Abstract Studies with negative results rarely hit the headlines. But the results are often just as important as the positive ones. A number of negative headline studies are looked at in this review intensive insulin therapy regime thrombolysis in cardiac arrest the effects of nutritional guidelines and rapid response outreach teams. Intensive insulin therapy The debate about intensive insulin therapy continues to be fought with a recent paper from Saudi Arabia by Arabi and colleagues 1 . In 2001 a landmark paper by van de Berghe and colleagues 2 showed that an intensive insulin regime resulted in a significantly lowered mortality in a surgical intensive care unit ICU compared to standard insulin therapy. As intensive insulin therapy is a relatively simple intervention with a promising survival benefit it is no wonder it was widely adopted by ICUs around the world. However a more cautious attitude has recently been adopted following the negative results of a follow-up study by van de Berghe in the medical ICU 3 and the results from the VISEP study 4 suggesting harm from tight glycaemic control. In Arabi s mixed medical and surgical ICU single-centred study 623 patients were randomly allocated to either intensive insulin therapy aiming to keep glucose levels between and mmol L or conventional insulin therapy between and mmol L . The primary end point of ICU mortality was used. A plethora of secondary end points were assessed including rates of hypoglycaemia. Results showed there was no statistical difference in