Girbes Armand R J, Beishuizen Albertus
VU Medisch Centrum, afd. Intensive Care Volwassenen, Amsterdam, The Netherlands.
Ned Tijdschr Geneeskd. 2009;153:A609.
Intensive insulin therapy for critically ill patients is implemented as standard therapy in many ICUs, even though the evidence supporting this approach comes from just two studies at a single centre. Moreover, the results could not be repeated in other multicenter trials and there is increasing evidence of a risk of hypoglycaemia. However, it appears that many intensive care specialists have been too zealous in their attempts to attain euglycemia during critical care. A recent RCT with over 6000 patients demonstrated that intensive glucose control increases mortality by 2.4%.
尽管支持这种方法的证据仅来自单一中心的两项研究，但在许多重症监护病房，强化胰岛素治疗已作为标准疗法应用于重症患者。此外，其他多中心试验无法重复这些结果，且有越来越多的证据表明存在低血糖风险。然而，许多重症监护专家在重症监护期间试图实现血糖正常的做法似乎过于激进。一项针对6000多名患者的近期随机对照试验表明，强化血糖控制会使死亡率增加2.4%。
