In critical care medicine, it is unlikely that any single study has had the influence to match that of the study by van den Berghe et al1 of intensive insulin therapy in surgical intensive care patients. Published in 2001, the study reported that targeting normoglycemia in ventilated patients in a surgical intensive care unit (ICU) reduced the risk of in-hospital death by one-third. Although the size of the treatment effect seemed improbable, the underlying concept had face validity as improved glycemic control had been proven beneficial in other patients with severe acute illness.2 As a result, tight glycemic control in critically ill adults is now recommended by numerous organizations including the American Diabetes Association3 and the Institute for Healthcare Improvement.4 In this issue of JAMA, Wiener and colleagues5 report a meta-analysis of studies examining tight glycemic control in critically ill adults; their conclusions, that tight glycemic control does not significantly reduce in-hospital mortality, may surprise many clinicians.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 26
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.