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Título : A randomized controlled trial comparing a computer-assisted insulin infusion protocol with a strict and a conventional protocol for glucose control in critically ill patients
Autor: Cavalcanti, Alexandre B.
Silva, Eliezer
Pereira, Adriano José
Caldeira-Filho, Milton
Almeida, Francisca P.
Westphal, Glauco A.
Beims, Renate
Fernandes, Caio C.
Correa, Thiago D.
Gouvea, Marcos R.
Eluf-Neto, José
Palavras-chave: Insulin
Hyperglycemia
Hypoglycemia
Blood Glucose
Critical Care
Insulina
Hiperglicemia
Hipoglicemia
Glicemia
Cuidados Críticos
Publicador: Elsevier
Data da publicação: 2009
Referência: CAVALCANTI, A. B. et al. A randomized controlled trial comparing a computer-assisted insulin infusion protocol with a strict and a conventional protocol for glucose control in critically ill patients. Journal of Critical Care, Orlando, v. 24, n. 3, p. 371–378, Sept. 2009.
Abstract: Purpose: The objective of this study is to evaluate blood glucose (BG) control efficacy and safety of 3 insulin protocols in medical intensive care unit (MICU) patients. Methods: This was a multicenter randomized controlled trial involving 167 MICU patients with at least one BG measurement ≥150 mg/dL and one or more of the following: mechanical ventilation, systemic inflammatory response syndrome, trauma, or burns. The interventions were computer-assisted insulin protocol (CAIP), with insulin infusion maintaining BG between 100 and 130 mg/dL; Leuven protocol, with insulin maintaining BG between 80 and 110 mg/dL; or conventional treatment—subcutaneous insulin if glucose >150 mg/dL. The main efficacy outcome was the mean of patients' median BG, and the safety outcome was the incidence of hypoglycemia (≤40 mg/dL). Results: The mean of patients' median BG was 125.0, 127.1, and 158.5 mg/dL for CAIP, Leuven, and conventional treatment, respectively (P = .34, CAIP vs Leuven; P < .001, CAIP vs conventional). In CAIP, 12 patients (21.4%) had at least one episode of hypoglycemia vs 24 (41.4%) in Leuven and 2 (3.8%) in conventional treatment (P = .02, CAIP vs Leuven; P= .006, CAIP vs conventional). Conclusions: The CAIP is safer than and as effective as the standard strict protocol for controlling glucose in MICU patients. Hypoglycemia was rare under conventional treatment. However, BG levels were higher than with IV insulin protocols.
URI: http://www.sciencedirect.com/science/article/pii/S0883944109001154
http://repositorio.ufla.br/jspui/handle/1/12313
Idioma: en_US
Aparece nas coleções:DSA - Artigos publicados em periódicos

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