Tags

Type your tag names separated by a space and hit enter

Impact of intensive insulin therapy on neuromuscular complications and ventilator dependency in the medical intensive care unit.
Am J Respir Crit Care Med. 2007 Mar 01; 175(5):480-9.AJ

Abstract

RATIONALE

Critical illness polyneuropathy/myopathy causes limb and respiratory muscle weakness, prolongs mechanical ventilation, and extends hospitalization of intensive care patients. Besides controlling risk factors, no specific prevention or treatment exists. Recently, intensive insulin therapy prevented critical illness polyneuropathy in a surgical intensive care unit.

OBJECTIVES

To investigate the impact of intensive insulin therapy on polyneuropathy/myopathy and treatment with prolonged mechanical ventilation in medical patients in the intensive care unit for at least 7 days.

METHODS

This was a prospectively planned subanalysis of a randomized controlled trial evaluating the effect of intensive insulin versus conventional therapy on morbidity and mortality in critically ill medical patients. All patients who were still in intensive care on Day 7 were screened weekly by electroneuromyography. The effect of intensive insulin therapy on critical illness polyneuropathy/myopathy and the relationship with duration of mechanical ventilation were assessed.

MEASUREMENTS AND MAIN RESULTS

Independent of risk factors, intensive insulin therapy reduced incidence of critical illness polyneuropathy/myopathy (107/212 [50.5%] to 81/208 [38.9%], p = 0.02). Treatment with prolonged (> or = 14 d) mechanical ventilation was reduced from 99 of 212 (46.7%) to 72 of 208 (34.6%) (p = 0.01). This was statistically only partially explained by prevention of critical illness polyneuropathy/myopathy.

CONCLUSION

In a subset of medical patients in the intensive care unit for at least 7 days, enrolled in a randomized controlled trial of intensive insulin therapy, those assigned to intensive insulin therapy had a reduced incidence of critical illness polyneuropathy/myopathy and were treated with prolonged mechanical ventilation less frequently.

Authors+Show Affiliations

Medical Intensive Care Unit, Department of Internal Medicine, University Hospitals Leuven, Herestraat 49, B-3000 Leuven, Belgium.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

17138955

Citation

Hermans, Greet, et al. "Impact of Intensive Insulin Therapy On Neuromuscular Complications and Ventilator Dependency in the Medical Intensive Care Unit." American Journal of Respiratory and Critical Care Medicine, vol. 175, no. 5, 2007, pp. 480-9.
Hermans G, Wilmer A, Meersseman W, et al. Impact of intensive insulin therapy on neuromuscular complications and ventilator dependency in the medical intensive care unit. Am J Respir Crit Care Med. 2007;175(5):480-9.
Hermans, G., Wilmer, A., Meersseman, W., Milants, I., Wouters, P. J., Bobbaers, H., Bruyninckx, F., & Van den Berghe, G. (2007). Impact of intensive insulin therapy on neuromuscular complications and ventilator dependency in the medical intensive care unit. American Journal of Respiratory and Critical Care Medicine, 175(5), 480-9.
Hermans G, et al. Impact of Intensive Insulin Therapy On Neuromuscular Complications and Ventilator Dependency in the Medical Intensive Care Unit. Am J Respir Crit Care Med. 2007 Mar 1;175(5):480-9. PubMed PMID: 17138955.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of intensive insulin therapy on neuromuscular complications and ventilator dependency in the medical intensive care unit. AU - Hermans,Greet, AU - Wilmer,Alexander, AU - Meersseman,Wouter, AU - Milants,Ilse, AU - Wouters,Pieter J, AU - Bobbaers,Herman, AU - Bruyninckx,Frans, AU - Van den Berghe,Greet, Y1 - 2006/11/30/ PY - 2006/12/2/pubmed PY - 2007/4/4/medline PY - 2006/12/2/entrez SP - 480 EP - 9 JF - American journal of respiratory and critical care medicine JO - Am J Respir Crit Care Med VL - 175 IS - 5 N2 - RATIONALE: Critical illness polyneuropathy/myopathy causes limb and respiratory muscle weakness, prolongs mechanical ventilation, and extends hospitalization of intensive care patients. Besides controlling risk factors, no specific prevention or treatment exists. Recently, intensive insulin therapy prevented critical illness polyneuropathy in a surgical intensive care unit. OBJECTIVES: To investigate the impact of intensive insulin therapy on polyneuropathy/myopathy and treatment with prolonged mechanical ventilation in medical patients in the intensive care unit for at least 7 days. METHODS: This was a prospectively planned subanalysis of a randomized controlled trial evaluating the effect of intensive insulin versus conventional therapy on morbidity and mortality in critically ill medical patients. All patients who were still in intensive care on Day 7 were screened weekly by electroneuromyography. The effect of intensive insulin therapy on critical illness polyneuropathy/myopathy and the relationship with duration of mechanical ventilation were assessed. MEASUREMENTS AND MAIN RESULTS: Independent of risk factors, intensive insulin therapy reduced incidence of critical illness polyneuropathy/myopathy (107/212 [50.5%] to 81/208 [38.9%], p = 0.02). Treatment with prolonged (> or = 14 d) mechanical ventilation was reduced from 99 of 212 (46.7%) to 72 of 208 (34.6%) (p = 0.01). This was statistically only partially explained by prevention of critical illness polyneuropathy/myopathy. CONCLUSION: In a subset of medical patients in the intensive care unit for at least 7 days, enrolled in a randomized controlled trial of intensive insulin therapy, those assigned to intensive insulin therapy had a reduced incidence of critical illness polyneuropathy/myopathy and were treated with prolonged mechanical ventilation less frequently. SN - 1073-449X UR - https://www.unboundmedicine.com/medline/citation/17138955/Impact_of_intensive_insulin_therapy_on_neuromuscular_complications_and_ventilator_dependency_in_the_medical_intensive_care_unit_ L2 - https://www.atsjournals.org/doi/10.1164/rccm.200605-665OC?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -