Euglycemic state reduces the incidence of critical illness polyneuropathy and duration of ventilator dependency in medical intensive care unit

Abstract

Objective: To examine the effect of euglycemic blood glucose control with normal insulin therapy on the incidence of critical illness polyneuropathy and duration of mechanical ventilation compared to that of conventional insulin therapy in a medical ICU.

Background: Despite the criticism over increased risk of hypoglycemia, the prevention of hyperglycemia through intensive insulin therapy has recently been confirmed to reduce the critical illness polyneuropathy (CIP).

Methods: In a single blind randomized clinical trial, forty adult patients admitted to the medical ICU were randomized to either euglycemic control (80-140 mg/dL) (Group N) or conventional approach (180-200 mg/dL, Group C). Duration of mechanical ventilation and the presence of CIP were investigated.

Results: The mean blood glucose levels were 131.76 ± 40.15 mg/dL in group N and 169.87 ± 50.66 mg/dL in group C (p < 0.001). Patients in group N were on mechanical ventilation for significantly less time than those in group C (p = 0.04). The diagnosis of CIP was significantly more frequent in group C than in group N (p = 0.01).

Conclusions: Glucose control at levels 80-140 mg/dL with normal insulin administration is likely to be associated with both reduced incidence of CIP and duration of ventilator dependency in medical ICU (Tab. 3, Ref. 24).