Does intensive insulin therapy really reduce mortality in critically ill surgical patients? A reanalysis of meta-analytic data

Critical Care

Volumn 14, Issue 5, 2010, Pages

  Friedrich, Jan O ^a,b,c   Chant, Clarence ^b   Adhikari, Neill K J ^a,d  

^a UNIVERSITY OF TORONTO   (Canada)

^b ST MICHAEL'S HOSPITAL   (Canada)

^c ST MICHAEL'S HOSPITAL   (Canada)

^d Institute of Clinical Evaluative Sciences   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

GLUCOSE; INSULIN;

ARTICLE; CRITICAL ILLNESS; CRITICALLY ILL PATIENT; GLUCOSE BLOOD LEVEL; HUMAN; INSULIN TREATMENT; INTENSIVE CARE UNIT; INTENSIVE INSULIN TREATMENT; META ANALYSIS (TOPIC); PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL (TOPIC); RISK ASSESSMENT; SURGICAL MORTALITY; SURGICAL PATIENT; SURGICAL WARD; SYSTEMATIC REVIEW; WARD; COMPARATIVE STUDY; INTENSIVE CARE; STANDARD; SURGERY;

CRITICAL ILLNESS; HUMANS; INSULIN; INTENSIVE CARE; META-ANALYSIS AS TOPIC; RANDOMIZED CONTROLLED TRIALS AS TOPIC; SURGICAL PROCEDURES, OPERATIVE;

EID: 79954456018     PISSN: 13648535     EISSN: 1466609X     Source Type: Journal    
DOI: 10.1186/cc9240     Document Type: Article

References (40)

1. Wiener RS, Wiener DC, Larson RJ. Benefits and risks of tight glucose control in critically ill adults: a meta-analysis. JAMA 2008, 300:933-944. 10.1001/jama.300.8.933, 18728267.
2. Griesdale DEG, de Souza RJ, van Dam RM, Heyland DK, Cook DJ, Malhotra A, Dhaliwal R, Henderson WR, Chittock DR, Finder S, Talmor D. Intensive insulin therapy and mortality among critically ill patients: a meta-analysis including NICE-SUGAR study data. CMAJ 2009, 180:821-827. 10.1503/cmaj.090206, 2665940, 19318387.
3. Van den Berghe G, Mesotten D, Vanhorebeek I. Intensive insulin therapy in the intensive care unit. CMAJ 2009, 180:799-800. 10.1503/cmaj.090500, 2665938, 19318386.
4. NICE-SUGAR Study Investigators Intensive versus conventional glucose control in critically ill patients. N Engl J Med 2009, 360:1283-1297. 10.1056/NEJMoa0810625, 19318384, NICE-SUGAR Study Investigators.
5. Farah R, Samokhvalov A, Zviebel F, Makhoul N. Insulin therapy of hyperglycemia in intensive care. Isr Med Assoc J 2007, 9:140-142.
6. Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med 2002, 21:1539-1558. 10.1002/sim.1186, 12111919.
7. Yu WK, Li WQ, Wang XD, Yan XW, Qi XP, Li N, Li JS. [Influence and mechanism of a tight control of blood glucose by intensive insulin therapy on human sepsis]. Zhonghua Wai Ke Za Zhi 2005, 43:29-32.
8. Mitchell I, Knight E, Gissane J, Tamhane R, Kolli R, Leditschke IA, Bellomo R, Finder S, . Australian and New Zealand Intensive Care Society Trials Group A phase II randomized controlled trial of intensive insulin therapy in general intensive care patients. Crit Care Resusc 2006, 8:289-293. Australian and New Zealand Intensive Care Society Trials Group.
9. Azevedo JRA, de Araujo LO, da Silva WS, de Azevado RP. A carbohydrate-restrictive strategy is safer and as efficient as intensive insulin therapy in critically ill patients. J Crit Care 2010, 25:84-89. 10.1016/j.jcrc.2008.10.011, 19327317.
10. McMullin J, Brozek J, McDonald E, Clarke F, Jaeschke R, Heels-Ansdell D, Leppert R, Foss A, Cook D. Lowering of glucose in critical care: a randomized pilot trial. J Crit Care 2007, 22:112-118. 10.1016/j.jcrc.2006.08.002, 17548021.
11. Preiser J-C, Devos P, Ruiz-Santana S, Mélot C, Annane D, Groeneveld J, Iapichino G, Leverve X, Nitenberg G, Singer P, Wernerman J, Joannidis M, Stecher A, Chioléro R. A prospective randomised multi-centre controlled trial on tight glucose control by intensive insulin therapy in adult intensive care units: the glucontrol study. Intensive Care Med 2009, 35:1738-1748. 10.1007/s00134-009-1585-2, 19636533.
12. Brunkhorst FM, Engel C, Bloos F, Meier-Hellmann A, Ragaller M, Weiler N, Moerer O, Gruendling M, Oppert M, Grond S, Olthoff D, Jaschinski U, John S, Rossaint R, Welte T, Schaefer M, Kern P, Kuhnt E, Kiehntopf M, Hartog C, Natanson C, Loeffler M, Reinhart K, . German Competence Network Sepsis Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med 2008, 358:125-139. 10.1056/NEJMoa070716, 18184958, German Competence Network Sepsis.
13. Iapichino G, Albicini M, Umbrello M, Sacconi F, Fermo I, Pavlovich R, Paroni R, Bellani G, Mistraletti G, Cugno M, Pesenti A, Gattinoni L. Tight glycemic control does not affect asymmetric-dimethylarginine in septic patients. Intensive Care Med 2008, 34:1843-1850. 10.1007/s00134-008-1158-9, 18504551.
14. He ZY, Li N, Xing J, Xie HA, Wu Y. Effect of intensive insulin therapy on shortterm outcome in critically ill patients [in Chinese]. Chinese J Clin Nutr 2008, 16:220-222.
15. Zhang RL, He W, Li T, Zhou H, Wang C, Gao S, Xu Y. Evaluation of optimal goal of glucose control in critically ill patients [in Chinese]. Chinese J Clin Nutr 2008, 16:204-208.
16. De La Rosa GC, Donado JH, Restrepo AH, Quintero AM, Gonzalez LG, Saldarriaga NE, Bedoya M, Toro JM, Velasquez JB, Valencia JC, Arango CM, Aleman PH, Vasquez EM, Chavarriaga JC, Yepes A, Pulido W, Cadavid CA, . Grupo de Investigacion en Cuidado intensivo Strict glycaemic control in patients hospitalised in a mixed medical and surgical intensive care unit: a randomised clinical trial. Crit Care 2008, 12:R120. 10.1186/cc7017, 2592751, 18799004, Grupo de Investigacion en Cuidado intensivo.
17. Arabi YM, Dabbagh OC, Tamim HM, Al-Shimemeri AA, Memish ZA, Haddad SH, Syed SJ, Giridhar HR, Rishu AH, Al-Daker MO, Kahoul SH, Britts RJ, Sakkijha MH. Intensive versus conventional insulin therapy: a randomized controlled trial in medical and surgical critically ill patients. Crit Care Med 2008, 36:3190-3197. 10.1097/CCM.0b013e31818f21aa, 18936702.
18. Mackenzie IM, Ercole A, Ingle S, Palmer CR. Glycaemic control and outcome in general intensive care: the East Anglian GLYCOGENIC study. Br J Intensive Care 2008, 18:121-126.
19. Henderson WR, Dhingra V, Chittock D, Foster D, Hebert P, Cook C, Heyland D, Dodek P, Griesdale D, Schulzer M, Ronco JJ, . Canadian Critical Care Trials Group The efficacy and safety of glucose control algorithms in intensive care. A pilot study of the Survival Using Glucose Algorithm Regulation (SUGAR) trial. Pol Arch Med Wewn 2009, 119:439-446. Canadian Critical Care Trials Group.
20. Wang LC, Lei S, Wu YC, Wu JN, Wang LF, Guan TR, Jiang HF, Ni HX, Ye XH. Intensive insulin therapy in critically ill patients [in Chinese]. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue 2006, 18:748-750.
21. Van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P, Bouillon R. Intensive insulin therapy in critically ill patients. N Engl J Med 2001, 345:1359-1367. 10.1056/NEJMoa011300, 11794168.
22. Grey NJ, Perdrizet GA. Reduction of nosocomial infections in the surgical intensive-care unit by strict glycemic control. Endocr Pract 2004, 10:46-52.
23. Bilotta F, Spinelli A, Giovannini F, Doronzio A, Delfini R, Rosa G. The effect of intensive insulin therapy on infection rate, vasospasm, neurologic outcome, and mortality in neurointensive care unit after intracranial aneurysm clipping in patients with acute subarachnoid hemorrhage: a randomized prospective pilot trial. J Neurosurg Anesthesiol 2007, 19:156-160. 10.1097/ANA.0b013e3180338e69, 17592345.
24. He W, Zhang TY, Zhou H, Li T, Zhao JY, Zhao D, Liu XH, Hou J, Wang C, Xu Y. Impact of intensive insulin therapy on surgical critically ill patients [in Chinese]. Zhonghua Wai Ke Za Zhi 2007, 45:1052-1054.
25. Bilotta F, Caramia R, Cernak I, Paoloni FP, Doronzio A, Cuzzone V, Santoro A, Rosa R. Intensive insulin therapy after severe traumatic brain injury: a randomized clinical trial. Neurocrit Care 2008, 9:159-166. 10.1007/s12028-008-9084-9, 18373223.
26. Bland DK, Fankhanel Y, Langford E, Lee M, Lee SW, Maloney C, Rogers M, Zimmerman G. Intensive versus modified conventional control of blood glucose level in medical intensive care patients: a pilot study. Am J Crit Care 2005, 14:370-376.
27. Van den Berghe G, Wilmer A, Hermans G, Meersseman W, Wouters PJ, Milants I, Van Wijngaerden E, Bobbaers H, Bouillon R. Intensive insulin therapy in the medical ICU. N Engl J Med 2006, 354:449-461. 10.1056/NEJMoa052521, 16452557.
28. Walters MR, Weir CJ, Lees KR. A randomised, controlled pilot study to investigate the potential benefit of intervention with insulin in hyperglycaemic acute ischaemic stroke patients. Cerebrovasc Dis 2006, 22:116-122. 10.1159/000093239, 16685123.
29. Oksanen T, Skrifvars MB, Varpula T, Kuitunen A, Pettila V, Nurmi J, Castren M. Strict versus moderate glucose control after resuscitation from ventricular fibrillation. Intensive Care Med 2007, 33:2093-2100. 10.1007/s00134-007-0876-8, 17928994.
30. Bruno A, Kent TA, Coull BM, Shankar RR, Saha C, Becker KJ, Kissela BM, Williams LS. Treatment of hyperglycemia in ischemic stroke (THIS): a randomized pilot trial. Stroke 2008, 39:384-389. 10.1161/STROKEAHA.107.493544, 18096840.
31. Ioannidis J, Patsopoulos N, Evangelou E. Uncertainty in heterogeneity estimates in meta-analyses. BMJ 2007, 335:914-916. 10.1136/bmj.39343.408449.80, 2048840, 17974687.
32. Stecher A, Steblaj S, Kermzar B, Invanova E. The influence of normoglycemia on ventilator-associated pneumonia in trauma patients. Proceedings of European Trauma Congress; May 24-26 2006; Ljubljana, Slovenia
33. Kia M, Botdorf J, Barber KR. The effects of strict glycemic control in the critically ill general and vascular surgical patient. Proceedings of 91st Annual Clinical Congress of the American College of Surgeons; October 16-20 2005; San Francisco, CA
34. Chan RPC, Galas FRBG, Hajjar LA, Bello CN, Piccioni MA, Auler JOC. Intensive perioperative glucose control does not improve outcomes of patients submitted to open-heart surgery: a randomized controlled trial. Clinics (Sao Paolo) 2009, 64:51-60.
35. Fernandez R, Boque M, Galera A, Rodriquez-Cintron W. Insulin: effect on mortality and renal failure in medical intensive care unit patients [abstract]. Proc Am Thor Soc 2005, 2:A37.
36. Davies RR, Newton RW, McNeill GP, Fisher BM, Kesson CM, Pearson D. Metabolic control in diabetic subjects following myocardial infarction: difficulties in improving blood glucose levels by intravenous insulin infusion. Scott Med J 1991, 36:74-76.
37. Gray CS, Hildreth AJ, Sandercock PA, O'Connell JE, Johnston DE, Cartlidge NEF, Bamford JM, James OF, Alberti KGMM, . GIST Trialists Collaboration Glucose- potassium-insulin infusions in the management of post-stroke hyperglycaemia: the UK Glucose Insulin in Stroke Trial (GIST-UK). Lancet Neurol 2007, 6:397-406. 10.1016/S1474-4422(07)70080-7, 17434094, GIST Trialists Collaboration.
38. Angus DC, Abraham E. Intensive insulin therapy in critical illness. Am J Respir Crit Care Med 2005, 172:1358-1359. 10.1164/rccm.2508009, 16301298.
39. Bellomo R, Egi M. Glycemic control in the intensive care unit: why we should wait for NICE-SUGAR. Mayo Clin Proc 2005, 80:1546-1548. 10.4065/80.12.1546, 16342646.
40. Marik PE, Preiser J-C. Towards understanding tight glycemic control in the ICU: a systematic review and meta-analysis. Chest 2010, 137:544-551. 10.1378/chest.09-1737, 20018803.