Therapeutics Randomised controlled trial
Tight glycaemic control does not improve mortality or morbidity in critically ill children 10.1136/eb-2014-101749
Sarah B Kandil, Edward Vincent S Faustino Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, USA Correspondence to: Dr Edward Vincent S Faustino, Department of Pediatrics, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA; [email protected]
Commentary on: Macrae D, Grieve R, Allen E, et al. A randomized trial of hyperglycemic control in pediatric intensive care. N Engl J Med 2014;370:107–18.
Context With tight glycaemic control (TGC), blood glucose is maintained at normal fasting levels with intravenous insulin. The efficacy and safety of TGC in critically ill patients is unclear. One study showed that TGC in the surgical intensive care unit reduced mortality and organ failure in critically ill adults1; however, subsequent trials failed to replicate these results. In fact, one multicentre trial showed higher mortality in critically ill adults undergoing TGC. Hypoglycaemia was more common with TGC.2 Macrae and colleagues aimed to determine whether TGC reduces mortality, morbidity and cost in critically ill children.
0.89). Severe hypoglycaemia, defined as blood glucose
Tight glycaemic control does not improve mortality or morbidity in critically ill children 10.1136/eb-2014-101749
Sarah B Kandil, Edward Vincent S Faustino Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, USA Correspondence to: Dr Edward Vincent S Faustino, Department of Pediatrics, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA; [email protected]
Commentary on: Macrae D, Grieve R, Allen E, et al. A randomized trial of hyperglycemic control in pediatric intensive care. N Engl J Med 2014;370:107–18.
Context With tight glycaemic control (TGC), blood glucose is maintained at normal fasting levels with intravenous insulin. The efficacy and safety of TGC in critically ill patients is unclear. One study showed that TGC in the surgical intensive care unit reduced mortality and organ failure in critically ill adults1; however, subsequent trials failed to replicate these results. In fact, one multicentre trial showed higher mortality in critically ill adults undergoing TGC. Hypoglycaemia was more common with TGC.2 Macrae and colleagues aimed to determine whether TGC reduces mortality, morbidity and cost in critically ill children.
0.89). Severe hypoglycaemia, defined as blood glucose
