tailieunhanh - Báo cáo y học: "Is it time for implementation of tight glycaemia control by intensive insulin therapy in every ICU"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: Is it time for implementation of tight glycaemia control by intensive insulin therapy in every ICU? | Available online http content 10 2 130 Commentary Is it time for implementation of tight glycaemia control by intensive insulin therapy in every ICU Philippe Devos and Jean-Charles Preiser Department of General Intensive Care University Hospital Centre University of Liege Domaine universitaire du Sart-Tilman B-4000 Liege Belgium Corresponding author Jean-Charles Preiser Published 21 March 2006 This article is online at http content 10 2 130 2006 BioMed Central Ltd Critical Care 2006 10 130 doi cc4871 Abstract The second study on tight glycaemia control by intensive insulin therapy IIT confirmed in medical intensive care unit patients the decrease in hospital mortality reported by the same team in the first IIT trial in surgical patients. However methodological concerns the high rate of hypoglycaemia in spite of the infusion of large doses of parenteral glucose and the frequent use of steroids presently preclude considering these results as recommendations in other intensive care units but rather argue for the need for large-scale assessment of the IIT approach by multi-centre studies to confirm the efficacy and safety of this therapeutic modality. In a recent issue of the New England Journal of Medicine Greet Van den Berghe and co-workers 1 published a confirmation of the life-saving effects of tight glycaemia control by intensive insulin therapy IIT in medical intensive care unit ICU patients. This second study intended to answer some of the questions and criticisms raised by the landmark Leuven study of 2001 which reported a 4 decrease in mortality in a surgical ICU population 2-7 . Hopefully these questions will be answered by the multicentre assessments of the effects of IIT the NICE-SUGAR and GLUCONTROL trials currently underway in Australia and Europe respectively 8 . Before the completion of these two indispensable studies Greet Van den Berghe and colleagues wanted to confirm the life-saving