By IANS
Washington : Doubts have been raised over the efficacy of administering intensive insulin therapy to all critically ill patients, according to a study.
The trial focused mainly on patients who had undergone cardiac surgery. A team from Harborview Medical Center and the University of Washington set out to explore the relationship between intensive insulin therapy and hospital mortality in a mixed population of critically ill patients. The study has been published in the open access journal Critical Care.
The researchers examined the outcomes of 10,456 patients admitted to the seven intensive care units (ICUs) of Harborview Medical Center, the only Level 1 trauma center in a five-state area of the northwest US, before and after the introduction of intensive insulin protocols.
The period of study from March 2001 to February 2005 was split into three consecutive sections: Period I (no specific glycemic control protocol), Period II (target glucose 80-130mg/dL) and Period III (target glucose 80-110mg/dL). The study population included a mix of trauma, surgical, neurosurgical and medical ICU patients.
They found that a policy of intensive insulin therapy was not associated with a decrease in hospital mortality.
While the proportion of patients receiving insulin infusions increased from nine percent in Period I to 42 percent n Period III, patients in Period III tended towards higher hospital mortality than those in Period I. Hospital mortality was increased in patients with an ICU stay of three days or less.
The authors suggest that further study is necessary before intensive insulin therapy is implemented widely in critically ill patients.