Intensive insulin therapy versus conventional insulin therapy for critically ill trauma patients admitted to ICU

Middle East J Anaesthesiol. 2010 Jun;20(5):659-66.

Abstract

Purpose: The objective of our study was to evaluate the beneficial effect of IIT in reducing mortality and morbidity in critically ill trauma patients admitted to ICU.

Method and material: Nested cohort study within a Randomized Controlled Trial. All trauma patients with GCS < or = 9 included in the original trial were included in this study. Primary outcome was ICU mortality.

Result: There was no difference in ICU mortality between IIT and CIT groups (6.5% vs. 5.5%, p = 0.67). After adjustment for baseline characteristics, IIT therapy was also not associated with mortality (Adjusted Hazard Ratio 1.33, 95% CI 0.35-5.05). IIT therapy was associated with a significant increase in the incidence of hypoglycemia as compared to CIT, at least one hypoglycemia episode occurred in 18.5% of patients in IIT and 1.3% in the CIT group (P < 0.0001).

Conclusion: IIT was not associated with survival improvement in trauma patients admitted to ICU and was associated with increased incidence of hypoglycemia.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Cohort Studies
  • Critical Illness
  • Female
  • Humans
  • Hypoglycemia / epidemiology
  • Insulin / administration & dosage*
  • Intensive Care Units*
  • Male
  • Middle Aged
  • Wounds and Injuries / blood
  • Wounds and Injuries / drug therapy*
  • Wounds and Injuries / mortality

Substances

  • Insulin