Intensive versus conventional glucose control in critically ill patients: A meta-analysis of randomized controlled trials |
| |
| Authors: | Yan Ling Xiaomu Li Xin Gao |
| |
| Affiliation: | 1. Department of Emergency, Xinhua Hospital, Shanghai Jiaotong University, Shanghai, China;2. Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China;1. John Curtin School of Medical Research, Australian National University, Australia;2. Cardiology Unit, The Canberra Hospital, Woden, ACT, Australia;1. Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China;2. Department of Cardiovascular Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China;3. Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China;1. Department of Hepatobiliary Surgery, Qingdao Municipal Hospital, Qingdao, China;2. Department of General Surgery, Weifang Medical University, Weifang, China;3. Department of Obstetrics and Gynecology, Qingdao Municipal Hospital, Qingdao, China;4. Department of Gastroenterology, Qingdao Municipal Hospital, Qingdao, China;5. Department of General Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Ji''nan, China;6. Department of General Surgery, Affiliated First People''s Hospital, Shanghai Jiao Tong University, Shanghai, China;2. Department of Anaesthesia and Intensive Care, Isala Clinics, Zwolle, The Netherlands;3. Department of Anaesthesia and Pain Therapy, Maastricht University Medical Centre, Maastricht, The Netherlands |
| |
| Abstract: | BackgroundCritically 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.MethodsA 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.ResultsTwenty 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).ConclusionsThis 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. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect PubMed 等数据库收录！ |
|
