[The influence of intensive insulin therapy on the mortality of critically ill patients in intensive care unit: a meta-analysis]

Abstract

Objective: To assess the influence of intensive insulin therapy (IIT), as compared with conventional insulin therapy (CIT), on mortality of critically ill patients in the intensive care unit (ICU) by Meta-analysis.

Methods: Computer retrieval was conducted to search for randomly controlled trials (1966-2009) to compare the result of IIT and CIT. The quality of included studies was critically evaluated and data were analyzed by using the Cochrane Collaboration's RevMan 5.0 software.

Results: A total of 23 studies were included in the Meta-analyses, consisting 11 216 patients. This Meta-analysis showed that there were significant difference between IIT and CIT in the mortality (unselected in the medical, surgical and mixed ICU), with significant lowering in IIT group. There was remarkable lowering of infection rate and the complication rate in IIT group compared with CIT group. However, the incidence of hypoglycemia was slightly lower in CIT group.

Conclusion: IIT tends to lower the mortality rate, infection rate, and complications in critically ill patients in the ICU as compared with CIT. Also with IIT the target blood glucose can be easier reached than CIT. The therapy can improve the quality of life. However, IIT is not as good as CIT in the control of hypoglycemia.