Intensive Insulin Improves Short-Term Outcomes in the Pediatric ICU — Physician’s First Watch

Medical News |
January 27, 2009

Intensive Insulin Improves Short-Term Outcomes in the Pediatric ICU

Critically ill children who receive intensive insulin therapy have shortened ICU stays and reduced mortality — despite an increased risk for hypoglycemia — according to a Lancet study published online.

Some 700 infants and children in the ICU of a Belgian hospital were randomized to receive intensive insulin infusion therapy (goal: age-adjusted normoglycemia) or conventional treatment (goal: glucose concentration no higher than 214 mg/dL).

Overall, the intensive-therapy group had shorter ICU stays than the conventional-therapy group (5.5 vs. 6.2 days), as well as lower mortality (3% vs. 6%). However, intensively treated patients were more likely to experience hypoglycemia (25% vs. 1%).

The authors say "the short-term benefits of preventing hyperglycemia in an ICU environment seem to outweigh the short-term risks of biochemical hypoglycemia." They call for additional research to examine long-term outcomes.

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