These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: A carbohydrate-restrictive strategy is safer and as efficient as intensive insulin therapy in critically ill patients.
    Author: de Azevedo JR, de Araujo LO, da Silva WS, de Azevedo RP.
    Journal: J Crit Care; 2010 Mar; 25(1):84-9. PubMed ID: 19327317.
    Abstract:
    PURPOSE: The aim of this study is to compare the safety and efficacy of 2 different strategies for glycemic control in critically ill adult patients. MATERIALS AND METHODS: A total of 337 patients were randomly assigned to a carbohydrate-restrictive strategy (group 1) through glucose-free venous hydration, hypoglycidic nutritional formula, and subcutaneous insulin if blood glucose level was higher than 180 mg/dL or to strict normalization of blood glucose levels (80-120 mg/dL) with the use of insulin infusion (group 2). RESULTS: Patients in group 1 (n = 169) received 2 (0-6.5) units of regular insulin per day, whereas patients in group 2 (n = 168) received 52 (35-74.5) units per day (P < .001). The median blood glucose level was 144 mg/dL in group 1 and 133.6 mg/dL in group 2 (P = .003). Hypoglycemia occurred in 6 (3.5%) patients in group 1 and 27 (16%) in group 2 (P < .001) and was an independent risk factor for neurological dysfunction and mortality. CONCLUSIONS: A carbohydrate-restrictive strategy reduced significantly the incidence of hypoglycemia in critically ill patients compared to intensive insulin therapy. Mortality and morbidity were comparable between the 2 groups.
    [Abstract] [Full Text] [Related] [New Search]