Intensive Insulin Therapy in Critically Ill Patients
Greet Van den Berghe, M.D., Ph.D., Pieter Wouters, M.Sc., Frank Weekers, M.D., Charles Verwaest, M.D., Frans Bruyninckx, M.D., Miet Schetz, M.D., Ph.D., Dirk Vlasselaers, M.D., Patrick Ferdinande, M.D., Ph.D., Peter Lauwers, M.D., and Roger Bouillon, M.D., Ph.D.
Background Hyperglycemia and insulin resistance are common incritically ill patients, even if they have not previously haddiabetes. Whether the normalization of blood glucose levelswith insulin therapy improves the prognosis for such patientsis not known.
Methods We performed a prospective, randomized, controlled studyinvolving adults admitted to our surgical intensive care unitwho were receiving mechanical ventilation. On admission, patientswere randomly assigned to receive intensive insulin therapy(maintenance of blood glucose at a level between 80 and 110mg per deciliter) or conventional treatment (infusion of insulinonly if the blood glucose level exceeded 215 mg per deciliterand maintenance of glucose at a level between 180 and 200 mgper deciliter).
Results At 12 months, with a total of 1548 patients enrolled,intensive insulin therapy reduced mortality during intensivecare from 8.0 percent with conventional treatment to 4.6 percent(P<0.04, with adjustment for sequential analyses). The benefitof intensive insulin therapy was attributable to its effecton mortality among patients who remained in the intensive careunit for more than five days (20.2 percent with conventionaltreatment, as compared with 10.6 percent with intensive insulintherapy; P=0.005). The greatest reduction in mortality involveddeaths due to multiple-organ failure with a proven septic focus.Intensive insulin therapy also reduced overall in-hospital mortalityby 34 percent, bloodstream infections by 46 percent, acute renalfailure requiring dialysis or hemofiltration by 41 percent,the median number of red-cell transfusions by 50 percent, andcritical-illness polyneuropathy by 44 percent, and patientsreceiving intensive therapy were less likely to require prolongedmechanical ventilation and intensive care.
Conclusions Intensive insulin therapy to maintain blood glucoseat or below 110 mg per deciliter reduces morbidity and mortalityamong critically ill patients in the surgical intensive careunit.
Source Information
From the Department of Intensive Care Medicine (G.V.B., P.W., F.W., C.V., M.S., D.V., P.F., P.L.), the Electromyography Laboratory, Department of Physical Medicine and Rehabilitation (F.B.), and the Laboratory for Experimental Medicine and Endocrinology (R.B.), Catholic University of Leuven, Leuven, Belgium.
Address reprint requests to Dr. Van den Berghe at the Department of Intensive Care Medicine, University Hospital Gasthuisberg, University of Leuven, B-3000 Leuven, Belgium, or at greta.vandenberghe{at}med.kuleuven.ac.be.
Intensive Insulin Therapy in Critically Ill Patients
Hirsch I. B., Coviello A., Mazuski J. E., Bailey J. A., Shapiro M. J., McCowen K. C., Maykel J. A., Bistrian B. R., Nusbaum N. J., van den Berghe G., Bouillon R., Lauwers P.
Extract |
Full Text |
PDF
N Engl J Med 2002;
346:1586-1588, May 16, 2002.
Correspondence
This article has been cited by other articles:
Zhai, L., Messina, J. L
(2009). Age and tissue specific differences in the development of acute insulin resistance following injury. J Endocrinol
203: 365-374
[Abstract][Full Text]
Johnston, K. C., Hall, C. E., Kissela, B. M., Bleck, T. P., Conaway, M. R., for the GRASP Investigators,
(2009). Glucose Regulation in Acute Stroke Patients (GRASP) Trial: A Randomized Pilot Trial. Stroke
40: 3804-3809
[Abstract][Full Text]
American College of Cardiology Foundation, , American Heart Association Task Force on Practice, , American Society of Echocardiography, , American Society of Nuclear Cardiology, , Heart Rhythm Society, , Society of Cardiovascular Anesthesiologists, , Society for Cardiovascular Angiography and Interve, , Society for Vascular Medicine, , Society for Vascular Surgery, , Fleisher, L. A., Beckman, J. A., Brown, K. A., Calkins, H., Chaikof, E. L., Fleischmann, K. E., Freeman, W. K., Froehlich, J. B., Kasper, E. K., Kersten, J. R., Riegel, B., Robb, J. F.
(2009). 2009 ACCF/AHA Focused Update on Perioperative Beta Blockade Incorporated Into the ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery. J Am Coll Cardiol
54: e13-e118
[Full Text]
2007 WRITING COMMITTEE MEMBERS, , Fleisher, L. A., Beckman, J. A., Brown, K. A., Calkins, H., Chaikof, E. L., Fleischmann, K. E., Freeman, W. K., Froehlich, J. B., Kasper, E. K., Kersten, J. R., Riegel, B., Robb, J. F.
(2009). 2009 ACCF/AHA Focused Update on Perioperative Beta Blockade Incorporated Into the ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation
120: e169-e276
[Full Text]
Ikeya, T., Broughton, S., Alic, N., Grandison, R., Partridge, L.
(2009). The endosymbiont Wolbachia increases insulin/IGF-like signalling in Drosophila. Proc R Soc B
276: 3799-3807
[Abstract][Full Text]
Authors/Task Force Members, , Poldermans, D., Bax, J. J., Boersma, E., De Hert, S., Eeckhout, E., Fowkes, G., Gorenek, B., Hennerici, M. G., Iung, B., Kelm, M., Kjeldsen, K. P., Kristensen, S. D., Lopez-Sendon, J., Pelosi, P., Philippe, F., Pierard, L., Ponikowski, P., Schmid, J.-P., Sellevold, O. F.M., Sicari, R., Van den Berghe, G., Vermassen, F., Additional Contributors, , Hoeks, S. E., Vanhorebeek, I., ESC Committee for Practice Guidelines (CPG), , Vahanian, A., Auricchio, A., Bax, J. J., Ceconi, C., Dean, V., Filippatos, G., Funck-Brentano, C., Hobbs, R., Kearney, P., McDonagh, T., McGregor, K., Popescu, B. A., Reiner, Z., Sechtem, U., Sirnes, P. A., Tendera, M., Vardas, P., Widimsky, P., Document Reviewers, , De Caterina, R., Agewall, S., Al Attar, N., Andreotti, F., Anker, S. D., Baron-Esquivias, G., Berkenboom, G., Chapoutot, L., Cifkova, R., Faggiano, P., Gibbs, S., Hansen, H. S., Iserin, L., Israel, C. W., Kornowski, R., Eizagaechevarria, N. M., Pepi, M., Piepoli, M., Priebe, H. J., Scherer, M., Stepinska, J., Taggart, D., Tubaro, M.
(2009). Guidelines for pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery: The Task Force for Preoperative Cardiac Risk Assessment and Perioperative Cardiac Management in Non-cardiac Surgery of the European Society of Cardiology (ESC) and endorsed by the European Society of Anaesthesiology (ESA). Eur Heart J
30: 2769-2812
[Full Text]
Flanders, S. J., Juneja, R., Roudebush, C. P., Carroll, J., Golas, A., Elias, B. L.
(2009). Glycemic Control and Insulin Safety: The Impact of Computerized Intravenous Insulin Dosing. American Journal of Medical Quality
24: 489-497
[Abstract]
MENEGHINI, L. F.
(2009). Perioperative management of diabetes: Translating evidence into practice. Cleveland Clinic Journal of Medicine
76: S53-S59
[Abstract][Full Text]
Ferrer, R., Artigas, A., Suarez, D., Palencia, E., Levy, M. M., Arenzana, A., Perez, X. L., Sirvent, J.-M., for the Edusepsis Study Group,
(2009). Effectiveness of Treatments for Severe Sepsis: A Prospective, Multicenter, Observational Study. Am. J. Respir. Crit. Care Med.
180: 861-866
[Abstract][Full Text]
Patel, G. W., Roderman, N., Lee, K. A, Charles, M. M, Nguyen, D., Beougher, P., Kleja, K., Casteneda, E.
(2009). Sliding Scale Versus Tight Glycemic Control in the Noncritically Ill at a Community Hospital. The Annals of Pharmacotherapy
43: 1774-1780
[Abstract][Full Text]
Gacouin, A., Barbarot, N., Camus, C., Salomon, S., Isslame, S., Marque, S., Lavoue, S., Donnio, P.-Y., Thomas, R., Le Tulzo, Y.
(2009). Late-Onset Ventilator-Associated Pneumonia in Nontrauma Intensive Care Unit Patients. Anesth. Analg.
109: 1584-1590
[Abstract][Full Text]
Arnold, L. M., Keller, D. L.
(2009). Hyperglycemia Management in Non-critically Ill Hospitalized Patients. Journal of Pharmacy Practice
22: 467-477
[Abstract]
Pleva, M., Mirtallo, J. M., Steinberg, S. M.
(2009). Hyperglycemic Events in Non-Intensive Care Unit Patients Receiving Parenteral Nutrition. Nutr Clin Pract
24: 626-634
[Abstract][Full Text]
Okabayashi, T., Nishimori, I., Yamashita, K., Sugimoto, T., Maeda, H., Yatabe, T., Kohsaki, T., Kobayashi, M., Hanazaki, K.
(2009). Continuous Postoperative Blood Glucose Monitoring and Control by Artificial Pancreas in Patients Having Pancreatic Resection: A Prospective Randomized Clinical Trial. Arch Surg
144: 933-937
[Abstract][Full Text]
Baker, E. H, Bell, D.
(2009). Blood glucose: of emerging importance in COPD exacerbations. Thorax
64: 830-832
[Full Text]
Chakrabarti, B, Angus, R M, Agarwal, S, Lane, S, Calverley, P M A
(2009). Hyperglycaemia as a predictor of outcome during non-invasive ventilation in decompensated COPD. Thorax
64: 857-862
[Abstract][Full Text]
Flaherty, K. R.
(2009). Clinical Year in Review IV: Pediatric Pulmonary and Critical Care, Cystic Fibrosis, Asthma, and Pleural Disease. Proc Am Thorac Soc
6: 506-511
[Full Text]
Vriesendorp, T M, Roos, Y B, Kruyt, N D, Biessels, G J, Kappelle, L J, Vermeulen, M, Holleman, F, DeVries, J H, Hoekstra, J B L
(2009). Efficacy and safety of two 5 day insulin dosing regimens to achieve strict glycaemic control in patients with acute ischaemic stroke. J. Neurol. Neurosurg. Psychiatry
80: 1040-1043
[Abstract][Full Text]
Joseph, J., Sinha, A., Paech, M., Walters, B. N J
(2009). Sepsis in pregnancy and early goal-directed therapy. Obstet Med
2: 93-99
[Abstract][Full Text]
Van den Berghe, G., Schetz, M., Vlasselaers, D., Hermans, G., Wilmer, A., Bouillon, R., Mesotten, D.
(2009). Intensive Insulin Therapy in Critically Ill Patients: NICE-SUGAR or Leuven Blood Glucose Target?. J. Clin. Endocrinol. Metab.
94: 3163-3170
[Abstract][Full Text]
Dunser, M. W., Hasibeder, W. R.
(2009). Sympathetic Overstimulation During Critical Illness: Adverse Effects of Adrenergic Stress. J Intensive Care Med
24: 293-316
[Abstract]
Webster, N. R., Galley, H. F.
(2009). Does strict glucose control improve outcome?. Br J Anaesth
103: 331-334
[Full Text]
Sourij, H., Schmolzer, I., Kettler-Schmut, E., Eder, M., Pressl, H., deCampo, A., Wascher, T. C.
(2009). Efficacy of a Continuous GLP-1 Infusion Compared With a Structured Insulin Infusion Protocol to Reach Normoglycemia in Nonfasted Type 2 Diabetic Patients: A Clinical Pilot Trial. Diabetes Care
32: 1669-1671
[Abstract][Full Text]
Cyrus, R. M, Szumita, P. M, Greenwood, B. C, Pendergrass, M. L
(2009). Evaluation of Compliance with a Paper-based, Multiplication-factor, Intravenous Insulin Protocol. The Annals of Pharmacotherapy
43: 1413-1418
[Abstract][Full Text]
Fuhrman, M. P.
(2009). Intradialytic Parenteral Nutrition and Intraperitoneal Nutrition. Nutr Clin Pract
24: 470-480
[Abstract][Full Text]
Garcia-Rodicio, S., Abajo, C., Godoy, M., Catala, M. A.
(2009). Development and Implementation of an Audit Tool for Quality Control of Parenteral Nutrition. Nutr Clin Pract
24: 500-507
[Abstract][Full Text]
Mebis, L., Paletta, D., Debaveye, Y., Ellger, B., Langouche, L., D'Hoore, A., Darras, V. M, Visser, T. J, Van den Berghe, G.
(2009). Expression of thyroid hormone transporters during critical illness. Eur J Endocrinol
161: 243-250
[Abstract][Full Text]
Szabo, Z., Andersson, R. G. G., Arnqvist, H. J.
(2009). Intraoperative muscle and fat metabolism in diabetic patients during coronary artery bypass grafting surgery: a parallel microdialysis and organ balance study. Br J Anaesth
103: 166-172
[Abstract][Full Text]
Okabayashi, T., Nishimori, I., Maeda, H., Yamashita, K., Yatabe, T., Hanazaki, K.
(2009). Effect of Intensive Insulin Therapy Using a Closed-Loop Glycemic Control System in Hepatic Resection Patients: A prospective randomized clinical trial. Diabetes Care
32: 1425-1427
[Abstract][Full Text]
Summers, D., Leonard, A., Wentworth, D., Saver, J. L., Simpson, J., Spilker, J. A., Hock, N., Miller, E., Mitchell, P. H., on behalf of the American Heart Association Counci,
(2009). Comprehensive Overview of Nursing and Interdisciplinary Care of the Acute Ischemic Stroke Patient: A Scientific Statement From the American Heart Association. Stroke
40: 2911-2944
[Full Text]
Weinrauch, L. A., Lewis, E. F.
(2009). Aiming for the best control of glycemia in patients with heart failure and type 2 diabetes the "sweet spot".. J Am Coll Cardiol
54: 429-431
[Full Text]
Kapoor, J. R., Kapoor, R.
(2009). Strict glucose control in the cardiac intensive care unit poised for real time?. J Am Coll Cardiol
54: 373-374
[Full Text]
Van den Berghe, G., Bouillon, R., Mesotten, D., Braithwaite, S. S., Pei, J., Yi, D., Khoo, T. K., Olsen, K. A., Mohammedi, K., Roussel, R., Marre, M., Hallas, P., Finfer, S., Chittock, D., the NICE-SUGAR Study Investigators,
(2009). Glucose control in critically ill patients.. NEJM
361: 89-90
[Full Text]
Marik, P.
(2009). Response. Chest
136: 324-324
[Full Text]
Mesotten, D., Wauters, J., Van den Berghe, G., Wouters, P. J., Milants, I., Wilmer, A.
(2009). The Effect of Strict Blood Glucose Control on Biliary Sludge and Cholestasis in Critically Ill Patients. J. Clin. Endocrinol. Metab.
94: 2345-2352
[Abstract][Full Text]
Correia, M. I. T. D.
(2009). Letter to the Editor. JPEN J Parenter Enteral Nutr
33: 453-454
[Full Text]
Badawi, O., Yeung, S. Y., Rosenfeld, B. A.
(2009). Evaluation of Glycemic Control Metrics for Intensive Care Unit Populations. American Journal of Medical Quality
24: 310-320
[Abstract]
Mowery, N. T., Dortch, M. J., Dossett, L. A., Norris, P. R., Diaz, J. J. Jr, Morris, J. A. Jr, May, A. K.
(2009). Review of a Large Clinical Series: Insulin Resistance Despite Tight Glucose Control Is Associated With Mortality in Critically Ill Surgical Patients. J Intensive Care Med
24: 242-251
[Abstract]
Cefalu, W. T.
(2009). Mortality and Glycemic Targets in the Intensive Care Unit: Another Paradigm Shift?. Diabetes
58: 1469-1470
[Full Text]
Dreier, J. P., Major, S., Manning, A., Woitzik, J., Drenckhahn, C., Steinbrink, J., Tolias, C., Oliveira-Ferreira, A. I., Fabricius, M., Hartings, J. A., Vajkoczy, P., Lauritzen, M., Dirnagl, U., Bohner, G., Strong, A. J., for the COSBID study group,
(2009). Cortical spreading ischaemia is a novel process involved in ischaemic damage in patients with aneurysmal subarachnoid haemorrhage. Brain
132: 1866-1881
[Abstract][Full Text]
Comi, R. J.
(2009). Glucose Control in the Intensive Care Unit: A Roller Coaster Ride or a Swinging Pendulum?. ANN INTERN MED
150: 809-811
[Abstract][Full Text]
McClave, S. A., Heyland, D. K.
(2009). The Physiologic Response and Associated Clinical Benefits From Provision of Early Enteral Nutrition. Nutr Clin Pract
24: 305-315
[Abstract][Full Text]
Foster, J. J., Pitts, W.
(2009). Implementation of an insulin therapy protocol: Applying the Baldrige approach. Am J Health Syst Pharm
66: 1035-1038
[Abstract][Full Text]
Adamovic, T., Willems, A., Vanasse, M., D'Anjou, G., Robitaille, Y., Litalien, C., Gauvin, F.
(2009). Critical Illness Polyneuromyopathy in a Child with Severe Demyelinating Myelitis. J Child Neurol
24: 758-762
[Abstract]
Moghissi, E. S., Korytkowski, M. T., DiNardo, M., Einhorn, D., Hellman, R., Hirsch, I. B., Inzucchi, S. E., Ismail-Beigi, F., Kirkman, M. S., Umpierrez, G. E.
(2009). American Association of Clinical Endocrinologists and American Diabetes Association Consensus Statement on Inpatient Glycemic Control. Diabetes Care
32: 1119-1131
[Full Text]
Olson, R. P., Bethel, M. A., Lien, L.
(2009). Preoperative Hypoglycemia in a Patient Receiving Insulin Detemir. Anesth. Analg.
108: 1836-1838
[Abstract][Full Text]
Shearer, A., Boehmer, M., Closs, M., Dela Rosa, R., Hamilton, J., Horton, K., McGrath, R., Schulman, C.
(2009). Comparison of Glucose Point-of-Care Values With Laboratory Values in Critically Ill Patients. Am J Crit Care
18: 224-230
[Abstract][Full Text]
McClave, S. A., Martindale, R. G., Vanek, V. W., McCarthy, M., Roberts, P., Taylor, B., Ochoa, J. B., Napolitano, L., Cresci, G., the A.S.P.E.N. Board of Directors, , the American College of Critical Care Medicine,
(2009). Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient:: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr
33: 277-316
[Full Text]
Verhaert, D., Thomas, J. D.
(2009). Dysglycemia and acute myocardial infarction the role of echocardiography.. J Am Coll Cardiol Img
2: 600-603
[Full Text]
Bratton, S. L.
(2009). Effects of Normalizing Blood Glucose on Outcomes of Intensive Care. AAP Grand Rounds
21: 57-57
[Full Text]
Gauglitz, G. G., Herndon, D. N., Kulp, G. A., Meyer, W. J. III, Jeschke, M. G.
(2009). Abnormal Insulin Sensitivity Persists up to Three Years in Pediatric Patients Post-Burn. J. Clin. Endocrinol. Metab.
94: 1656-1664
[Abstract][Full Text]
Blaha, J., Kopecky, P., Matias, M., Hovorka, R., Kunstyr, J., Kotulak, T., Lips, M., Rubes, D., Stritesky, M., Lindner, J., Semrad, M., Haluzik, M.
(2009). Comparison of Three Protocols for Tight Glycemic Control in Cardiac Surgery Patients. Diabetes Care
32: 757-761
[Abstract][Full Text]
Bellomo, R., Egi, M.
(2009). What Is a NICE-SUGAR for Patients in the Intensive Care Unit?. Mayo Clin Proc.
84: 400-402
[Full Text]
Latorre, J. G. S., Chou, S. H.-Y., Nogueira, R. G., Singhal, A. B., Carter, B. S., Ogilvy, C. S., Rordorf, G. A.
(2009). Effective Glycemic Control With Aggressive Hyperglycemia Management Is Associated With Improved Outcome in Aneurysmal Subarachnoid Hemorrhage. Stroke
40: 1644-1652
[Abstract][Full Text]
Mayer, S. A., Schwab, S.
(2009). Advances in Critical Care and Emergency Medicine. Stroke
40: e298-e300
[Full Text]
Marfella, R., Di Filippo, C., Portoghese, M., Ferraraccio, F., Rizzo, M. R., Siniscalchi, M., Musacchio, E., D'Amico, M., Rossi, F., Paolisso, G.
(2009). Tight Glycemic Control Reduces Heart Inflammation and Remodeling During Acute Myocardial Infarction in Hyperglycemic Patients. J Am Coll Cardiol
53: 1425-1436
[Abstract][Full Text]
Kosiborod, M., Inzucchi, S. E., Goyal, A., Krumholz, H. M., Masoudi, F. A., Xiao, L., Spertus, J. A.
(2009). Relationship Between Spontaneous and Iatrogenic Hypoglycemia and Mortality in Patients Hospitalized With Acute Myocardial Infarction. JAMA
301: 1556-1564
[Abstract][Full Text]
Griesdale, D. E.G., de Souza, R. J., van Dam, R. M., Heyland, D. K., Cook, D. J., Malhotra, A., Dhaliwal, R., Henderson, W. R., Chittock, D. R., Finfer, S., Talmor, D.
(2009). Intensive insulin therapy and mortality among critically ill patients: a meta-analysis including NICE-SUGAR study data. CMAJ
180: 821-827
[Abstract][Full Text]
Van den Berghe, G., Mesotten, D., Vanhorebeek, I.
(2009). Intensive insulin therapy in the intensive care unit. CMAJ
180: 799-800
[Full Text]
Kosiborod, M., Inzucchi, S. E., Spertus, J. A., Wang, Y., Masoudi, F. A., Havranek, E. P., Krumholz, H. M.
(2009). Elevated Admission Glucose and Mortality in Elderly Patients Hospitalized With Heart Failure. Circulation
119: 1899-1907
[Abstract][Full Text]
Lopez, V.
(2009). Review: tight glucose control increases risk of hypoglycaemia but not short-term mortality in critically ill adults. Evid. Based Nurs.
12: 51-51
[Full Text]
Umpierrez, G. E.
(2009). Basal Versus Sliding-Scale Regular Insulin in Hospitalized Patients With Hyperglycemia During Enteral Nutrition Therapy. Diabetes Care
32: 751-753
[Full Text]
Moller, N., Jorgensen, J. O. L.
(2009). Effects of Growth Hormone on Glucose, Lipid, and Protein Metabolism in Human Subjects. Endocr. Rev.
30: 152-177
[Abstract][Full Text]
Chakkera, H. A., Weil, E. J., Castro, J., Heilman, R. L., Reddy, K. S., Mazur, M. J., Hamawi, K., Mulligan, D. C., Moss, A. A., Mekeel, K. L., Cosio, F. G., Cook, C. B.
(2009). Hyperglycemia during the Immediate Period after Kidney Transplantation. CJASN
4: 853-859
[Abstract][Full Text]
Weant, K. A, Ladha, A.
(2009). Conversion from Continuous Insulin Infusions to Subcutaneous Insulin in Critically Ill Patients. The Annals of Pharmacotherapy
43: 629-634
[Abstract][Full Text]
Inzucchi, S. E., Siegel, M. D.
(2009). Glucose Control in the ICU -- How Tight Is Too Tight?. NEJM
360: 1346-1349
[Full Text]
The NICE-SUGAR Study Investigators,
(2009). Intensive versus Conventional Glucose Control in Critically Ill Patients. NEJM
360: 1283-1297
[Abstract][Full Text]
Comi, R. J., Jacoby, J., Basta, D., Wood, M., Butterly, J.
(2009). Improving Glucose Management by Redesigning the Care of Diabetic Inpatients Using a Nurse Practitioner Service. Clin. Diabetes
27: 78-81
[Full Text]
Cryer, P. E., Axelrod, L., Grossman, A. B., Heller, S. R., Montori, V. M., Seaquist, E. R., Service, F. J.
(2009). Evaluation and Management of Adult Hypoglycemic Disorders: An Endocrine Society Clinical Practice Guideline. J. Clin. Endocrinol. Metab.
94: 709-728
[Abstract][Full Text]
Derr, R. L., Ye, X., Islas, M. U., Desideri, S., Saudek, C. D., Grossman, S. A.
(2009). Association Between Hyperglycemia and Survival in Patients With Newly Diagnosed Glioblastoma. JCO
27: 1082-1086
[Abstract][Full Text]
Engberding, N., San Martin, A., Martin-Garrido, A., Koga, M., Pounkova, L., Lyons, E., Lassegue, B., Griendling, K. K.
(2009). Insulin-Like Growth Factor-1 Receptor Expression Masks the Antiinflammatory and Glucose Uptake Capacity of Insulin in Vascular Smooth Muscle Cells. Arterioscler. Thromb. Vasc. Bio.
29: 408-415
[Abstract][Full Text]
Schneider, A., Bottiger, B. W., Popp, E.
(2009). Cerebral Resuscitation After Cardiocirculatory Arrest. Anesth. Analg.
108: 971-979
[Abstract][Full Text]
Bederson, J. B., Connolly, E. S. Jr, Batjer, H. H., Dacey, R. G., Dion, J. E., Diringer, M. N., Duldner, J. E. Jr, Harbaugh, R. E., Patel, A. B., Rosenwasser, R. H.
(2009). Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage: A Statement for Healthcare Professionals From a Special Writing Group of the Stroke Council, American Heart Association. Stroke
40: 994-1025
[Full Text]
Fiaccadori, E., Regolisti, G., Cabassi, A.
(2009). Specific nutritional problems in acute kidney injury, treated with non-dialysis and dialytic modalities. NDT Plus
0: sfp017v1-sfp017
[Abstract][Full Text]
Ceriello, A., Zarich, S. W., Testa, R.
(2009). Lowering glucose to prevent adverse cardiovascular outcomes in a critical care setting.. J Am Coll Cardiol
53: S9-13
[Abstract][Full Text]
Dandona, P., Chaudhuri, A., Ghanim, H., Mohanty, P.
(2009). Insulin as an anti-inflammatory and antiatherogenic modulator.. J Am Coll Cardiol
53: S14-S20
[Abstract][Full Text]
Balasubramanyam, A.
(2009). Intensive Glycemic Control in the Intensive Care Unit: Promises and Pitfalls. J. Clin. Endocrinol. Metab.
94: 416-417
[Full Text]
Lazar, H. L., McDonnell, M., Chipkin, S. R., Furnary, A. P., Engelman, R. M., Sadhu, A. R., Bridges, C. R., Haan, C. K., Svedjeholm, R., Taegtmeyer, H., Shemin, R. J.
(2009). The society of thoracic surgeons practice guideline series: blood glucose management during adult cardiac surgery.. Ann. Thorac. Surg.
87: 663-669
[Full Text]
van der Crabben, S. N., Blumer, R. M. E., Stegenga, M. E., Ackermans, M. T., Endert, E., Tanck, M. W. T., Serlie, M. J., van der Poll, T., Sauerwein, H. P.
(2009). Early Endotoxemia Increases Peripheral and Hepatic Insulin Sensitivity in Healthy Humans. J. Clin. Endocrinol. Metab.
94: 463-468
[Abstract][Full Text]
Umpierrez, G. E., Hor, T., Smiley, D., Temponi, A., Umpierrez, D., Ceron, M., Munoz, C., Newton, C., Peng, L., Baldwin, D.
(2009). Comparison of Inpatient Insulin Regimens with Detemir plus Aspart Versus Neutral Protamine Hagedorn plus Regular in Medical Patients with Type 2 Diabetes. J. Clin. Endocrinol. Metab.
94: 564-569
[Abstract][Full Text]
Van den Berghe, G., Vlasselaers, D., Vanhorebeek, I., Fendler, W. M., Mlynarski, W. M., Beardsall, K., de Zegher, F., Dunger, D. B., the NIRTURE Investigators, , Kashyap, S., Polin, R. A.
(2009). Insulin Therapy in Very-Low-Birth-Weight Infants. NEJM
360: 535-537
[Full Text]
Cook, A., Laughlin, D., Moore, M., North, D., Wilkins, K., Wong, G., Wallace-Scroggs, A., Halvorsen, L.
(2009). Differences in Glucose Values Obtained From Point-of-Care Glucose Meters and Laboratory Analysis in Critically Ill Patients. Am J Crit Care
18: 65-72
[Abstract][Full Text]
Kruse, J. A.
(2009). Endocrine Emergencies. ACCP Crit Care Med Brd Rev
20: 369-380
[Full Text]
Drover, J. W.
(2009). Nutritional Support in the Critically Ill Patient. ACCP Crit Care Med Brd Rev
20: 403-412
[Full Text]
Gropper, M. A.
(2009). Issues in Postoperative Management: Postoperative Pain Management and Intensive Glycemic Control. ACCP Crit Care Med Brd Rev
20: 425-432
[Full Text]
Gropper, M. A.
(2009). Issues in Sedation, Paralytic Agents, and Airway Management. ACCP Crit Care Med Brd Rev
20: 473-484
[Full Text]
Li, L., Thompson, L. H., Zhao, L., Messina, J. L.
(2009). Tissue-Specific Difference in the Molecular Mechanisms for the Development of Acute Insulin Resistance after Injury. Endocrinology
150: 24-32
[Abstract][Full Text]
Dossett, L. A., Collier, B., Donahue, R., Mowery, N. T., Dortch, M. J., Guillamondegui, O., Diaz, J. J., May, A. K.
(2009). Intensive Insulin Therapy in Practice: Can We Do It?. JPEN J Parenter Enteral Nutr
33: 14-20
[Abstract][Full Text]
Pohl, M., Mayr, P., Mertl-Roetzer, M., Lauster, F., Haslbeck, M., Hipper, B., Steube, D., Tietjen, M., Eriksen, J., Rahlfs, V. W.
(2009). Glycemic Control in Patients With Type 2 Diabetes Mellitus With a Disease-Specific Enteral Formula: Stage II of a Randomized, Controlled Multicenter Trial. JPEN J Parenter Enteral Nutr
33: 37-49
[Abstract][Full Text]
Li Yumin, , Chen Hao, , Li Xun, , Zhou Wence, , He Minyan, , Chiriva-Internati, M., Wachtel, M.S., Frezza, E.E.
(2009). A New Immunomodulatory Therapy for Severe Sepsis: Ulinastatin Plus Thymosin {alpha} 1. J Intensive Care Med
24: 47-53
[Abstract]
