Tags

Type your tag names separated by a space and hit enter

Intensive versus conventional glucose control in critically ill patients: a meta-analysis of randomized controlled trials.
Eur J Intern Med. 2012 Sep; 23(6):564-74.EJ

Abstract

BACKGROUND

Critically ill patients commonly develop hyperglycemia. It remains unclear, however, to what extent correcting hyperglycemia will benefit these patients. We performed this meta-analysis to evaluate the benefits and risks of intensive glucose control versus conventional glucose control in critically ill adult patients.

METHODS

A systematic literature search of MEDLINE, PubMed, and Cochrane databases (until June 2011) was conducted using specific search terms. Randomized controlled trials that compared intensive glucose control with a target glucose goal <6.1 mmol/l (110 mg/dl) to conventional glucose control in adult intensive care patients were included. The random-effect model was used to estimate the pooled risk ratio of the two treatment arms.

RESULTS

Twenty two studies that randomized 13,978 participants were included in the meta-analysis. Overall, intensive glucose control did not reduce the short-term mortality (RR=1.02, 95% CI: 0.95-1.10, p=0.51), 90 day or 180 day mortality (RR=1.06, 95% CI: 0.99-1.13, p=0.08), sepsis (RR=0.96, 95% CI: 0.83-1.12, p=0.59) or new need for dialysis (RR=0.96, 95% CI: 0.83-1.11, p=0.57). The incidence of hypoglycemia was significantly higher in intensive glucose control group compared with conventional glucose control group (RR=5.01, 95% CI: 3.45-7.28, p<0.00001).

CONCLUSIONS

This meta-analysis found that intensive glucose control in critically ill adults did not reduce mortality but is associated with a significantly increased risk of hypoglycemia.

Authors+Show Affiliations

Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University No. 180 Fenglin Road, Shanghai 200032, China.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22863436

Citation

Ling, Yan, et al. "Intensive Versus Conventional Glucose Control in Critically Ill Patients: a Meta-analysis of Randomized Controlled Trials." European Journal of Internal Medicine, vol. 23, no. 6, 2012, pp. 564-74.
Ling Y, Li X, Gao X. Intensive versus conventional glucose control in critically ill patients: a meta-analysis of randomized controlled trials. Eur J Intern Med. 2012;23(6):564-74.
Ling, Y., Li, X., & Gao, X. (2012). Intensive versus conventional glucose control in critically ill patients: a meta-analysis of randomized controlled trials. European Journal of Internal Medicine, 23(6), 564-74. https://doi.org/10.1016/j.ejim.2012.02.013
Ling Y, Li X, Gao X. Intensive Versus Conventional Glucose Control in Critically Ill Patients: a Meta-analysis of Randomized Controlled Trials. Eur J Intern Med. 2012;23(6):564-74. PubMed PMID: 22863436.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intensive versus conventional glucose control in critically ill patients: a meta-analysis of randomized controlled trials. AU - Ling,Yan, AU - Li,Xiaomu, AU - Gao,Xin, Y1 - 2012/03/24/ PY - 2011/12/26/received PY - 2012/02/28/accepted PY - 2012/8/7/entrez PY - 2012/8/7/pubmed PY - 2013/1/5/medline SP - 564 EP - 74 JF - European journal of internal medicine JO - Eur J Intern Med VL - 23 IS - 6 N2 - BACKGROUND: Critically ill patients commonly develop hyperglycemia. It remains unclear, however, to what extent correcting hyperglycemia will benefit these patients. We performed this meta-analysis to evaluate the benefits and risks of intensive glucose control versus conventional glucose control in critically ill adult patients. METHODS: A systematic literature search of MEDLINE, PubMed, and Cochrane databases (until June 2011) was conducted using specific search terms. Randomized controlled trials that compared intensive glucose control with a target glucose goal <6.1 mmol/l (110 mg/dl) to conventional glucose control in adult intensive care patients were included. The random-effect model was used to estimate the pooled risk ratio of the two treatment arms. RESULTS: Twenty two studies that randomized 13,978 participants were included in the meta-analysis. Overall, intensive glucose control did not reduce the short-term mortality (RR=1.02, 95% CI: 0.95-1.10, p=0.51), 90 day or 180 day mortality (RR=1.06, 95% CI: 0.99-1.13, p=0.08), sepsis (RR=0.96, 95% CI: 0.83-1.12, p=0.59) or new need for dialysis (RR=0.96, 95% CI: 0.83-1.11, p=0.57). The incidence of hypoglycemia was significantly higher in intensive glucose control group compared with conventional glucose control group (RR=5.01, 95% CI: 3.45-7.28, p<0.00001). CONCLUSIONS: This meta-analysis found that intensive glucose control in critically ill adults did not reduce mortality but is associated with a significantly increased risk of hypoglycemia. SN - 1879-0828 UR - https://www.unboundmedicine.com/medline/citation/22863436/Intensive_versus_conventional_glucose_control_in_critically_ill_patients:_a_meta_analysis_of_randomized_controlled_trials_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0953-6205(12)00066-0 DB - PRIME DP - Unbound Medicine ER -