Tanaka Aiko, Yatabe Tomoaki, Suhara Tomohiro, Egi Moritoki
Department of Intensive Care, University of Fukui Hospital, 23-3 Matsuoka Shimoaizuki, Eiheiji-Cho, Yoshida, Fukui, 910-1193, Japan.
Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka, 565-0871, Japan.
J Intensive Care. 2024 Apr 14;12(1):14. doi: 10.1186/s40560-024-00728-0.
Acute glycemic control significantly affects the clinical outcomes of critically ill patients. This updated network meta-analysis examines the benefits and harms of four target blood glucose levels (< 110, 110-144, 144-180, and > 180 mg/dL). Analyzing data of 27,541 patients from 37 trials, the surface under the cumulative ranking curve for mortality and hypoglycemia was highest at a target blood glucose level of 144-180 mg/dL, while for infection and acute kidney injury at 110-144 mg/dL. Further evidence is needed to determine whether 110-144 or 144-180 mg/dL is superior as an optimal glucose target, considering prioritized outcomes.
急性血糖控制显著影响危重症患者的临床结局。这项更新的网状荟萃分析探讨了四个目标血糖水平（<110、110 - 144、144 - 180和>180mg/dL）的利弊。分析来自37项试验的27541例患者的数据，死亡率和低血糖累积排名曲线下面积在目标血糖水平为144 - 180mg/dL时最高，而感染和急性肾损伤在110 - 144mg/dL时最高。考虑到优先结局，需要进一步的证据来确定110 - 144mg/dL还是144 - 180mg/dL作为最佳血糖目标更具优势。
