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Links > Intensive Insulin Therapy in Critically Ill Patients
A significant change in patient management has occurred over the past few years with respect to the monitoring and therapeutic control of blood glucose to normoglycemic levels (now know as Tight Glucose Control or TGC). In this now often referenced study by Dr. Greet Van den Berghe and her colleagues at the University Hospital in Leuven, Belgium, published in the New England Journal of Medicine (November 2001), 1548 post-surgical ICU patients were randomized either to an aggressive glucose control arm (maintaining blood glucose between 80-110 mg/dL) or to previously accepted norms (below 300 mg/dL). The dramatic improvement in clinical outcome in the TGC group is summarized below:
- 46% reduction in the incidence of Blood Stream Infections/Sepsis
- 41% reduction in Acute Renal Failure requiring dialysis or hemofiltration
- 50% reduction in the need for Red-Cell Transfusions
- 44% reduction in the incidence of Poly Neuropathies
- 42% reduction in Mortality during intensive care
- 34% reduction in overall in-hospital patient Mortality
View this article online at the New England Journal of Medicine website.