Tight glycaemic control in the intensive care unit: pitfalls in the testing of the concept
- PMID: 18957141
- PMCID: PMC2592765
- DOI: 10.1186/cc7086
Tight glycaemic control in the intensive care unit: pitfalls in the testing of the concept
Abstract
Tight glycaemic control emerged on the scene of critical care in 2001. Surprisingly, not many confirmation trials have been published so far. The randomised controlled trial by De La Rosa and colleagues is a timely and valuable attempt to repeat the landmark Leuven studies. The failure to replicate the beneficial effects of tight glycaemic control may boil down to some less obvious defaults in the set-up of the trial despite a seemingly adequate study design. The incorporation of ample power calculations and strict adherence to glucose targets are essential to fairly compare studies on tight blood glucose control. Only if these basic conditions of study design are fulfilled can the effectiveness of the therapy be assessed.
Comment in
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Recent literature regarding tight glycemic control: pitfalls in the sweet debate.Crit Care. 2009;13(2):408. doi: 10.1186/cc7750. Epub 2009 Apr 30. Crit Care. 2009. PMID: 19439054 Free PMC article. No abstract available.
Comment on
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Strict glycaemic control in patients hospitalised in a mixed medical and surgical intensive care unit: a randomised clinical trial.Crit Care. 2008;12(5):R120. doi: 10.1186/cc7017. Epub 2008 Sep 17. Crit Care. 2008. PMID: 18799004 Free PMC article. Clinical Trial.
References
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- De La Rosa GD, Donado JH, Restrepo AH, Quintero AM, Gonzalez LG, Saldarriaga NE, Bedoya MT, Toro JM, Velasquez JB, Valencia JC, Arango CM, Aleman PH, Vasquez EM, Chavarriaga JC, Yepes A, Pulido W, Cadavid CA. Strict glycemic control in patients hospitalized in a mixed medical and surgical intensive care unit: a randomized clinical trial. Crit Care. 2008;12:R120. doi: 10.1186/cc7017. - DOI - PMC - PubMed
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- Krinsley JS. Effect of an intensive glucose management protocol on the mortality of critically ill adult patients. Mayo Clin Proc. 2004;79:992–1000. - PubMed
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- NICE-SUGAR study design http://www.clinicaltrials.gov/ct2/show/NCT00220987
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