Greet Van den Berghe, M.D., Ph.D., Alexander Wilmer, M.D., Ph.D., Greet Hermans, M.D., Wouter Meersseman, M.D., Pieter J. Wouters, M.Sc., Ilse Milants, R.N., Eric Van Wijngaerden, M.D., Ph.D., Herman Bobbaers, M.D., Ph.D., and Roger Bouillon, M.D., Ph.D.
Background Intensive insulin therapy reduces morbidity and mortalityin patients in surgical intensive care units (ICUs), but itsrole in patients in medical ICUs is unknown.
Methods In a prospective, randomized, controlled study of adultpatients admitted to our medical ICU, we studied patients whowere considered to need intensive care for at least three days.On admission, patients were randomly assigned to strict normalizationof blood glucose levels (80 to 110 mg per deciliter [4.4 to6.1 mmol per liter]) with the use of insulin infusion or toconventional therapy (insulin administered when the blood glucoselevel exceeded 215 mg per deciliter [12 mmol per liter], withthe infusion tapered when the level fell below 180 mg per deciliter[10 mmol per liter]). There was a history of diabetes in 16.9percent of the patients.
Results In the intention-to-treat analysis of 1200 patients,intensive insulin therapy reduced blood glucose levels but didnot significantly reduce in-hospital mortality (40.0 percentin the conventional-treatment group vs. 37.3 percent in theintensive-treatment group, P=0.33). However, morbidity was significantlyreduced by the prevention of newly acquired kidney injury, acceleratedweaning from mechanical ventilation, and accelerated dischargefrom the ICU and the hospital. Although length of stay in theICU could not be predicted on admission, among 433 patientswho stayed in the ICU for less than three days, mortality wasgreater among those receiving intensive insulin therapy. Incontrast, among 767 patients who stayed in the ICU for threeor more days, in-hospital mortality in the 386 who receivedintensive insulin therapy was reduced from 52.5 to 43.0 percent(P=0.009) and morbidity was also reduced.
Conclusions Intensive insulin therapy significantly reducedmorbidity but not mortality among all patients in the medicalICU. Although the risk of subsequent death and disease was reducedin patients treated for three or more days, these patients couldnot be identified before therapy. Further studies are neededto confirm these preliminary data. (ClinicalTrials.gov number,NCT00115479
[ClinicalTrials.gov]
.)
Source Information
From the Departments of Intensive Care Medicine (G.V.B., P.J.W., I.M.) and Medical Intensive Care Medicine (A.W., G.H., W.M., E.V.W., H.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, Catholic University of Leuven, B-3000 Leuven, Belgium, or at greta.vandenberghe{at}med.kuleuven.be.
Intensive Insulin Therapy in the Medical ICU
Hammer L., Dessertaine G., Timsit J.-F., Aberegg S. K., Tamler R., LeRoith D., Roth J., Van den Berghe G., Wilmer A., Bouillon R., Malhotra A.
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N Engl J Med 2006;
354:2069-2071, May 11, 2006.
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[Full Text]
MENEGHINI, L. F.
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[Abstract][Full Text]
Patel, G. W., Roderman, N., Lee, K. A, Charles, M. M, Nguyen, D., Beougher, P., Kleja, K., Casteneda, E.
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43: 1774-1780
[Abstract][Full Text]
Arnold, L. M., Keller, D. L.
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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
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[Abstract][Full Text]
Okabayashi, T., Nishimori, I., Yamashita, K., Sugimoto, T., Maeda, H., Yatabe, T., Kohsaki, T., Kobayashi, M., Hanazaki, K.
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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
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[Abstract][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
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[Abstract][Full Text]
Joseph, J., Sinha, A., Paech, M., Walters, B. N J
(2009). Sepsis in pregnancy and early goal-directed therapy. Obstet Med
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[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]
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]
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
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[Abstract][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]
Turchin, A., Matheny, M. E., Shubina, M., Scanlon, J. V., Greenwood, B., Pendergrass, M. L.
(2009). Hypoglycemia and Clinical Outcomes in Patients With Diabetes Hospitalized in the General Ward. Diabetes Care
32: 1153-1157
[Abstract][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]
Cefalu, W. T.
(2009). Mortality and Glycemic Targets in the Intensive Care Unit: Another Paradigm Shift?. Diabetes
58: 1469-1470
[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]
Fowler, M. J.
(2009). Inpatient Diabetes Management. Clin. Diabetes
27: 119-122
[Full Text]
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]
Kruyt, N. D., Biessels, G. J., de Haan, R. J., Vermeulen, M., Rinkel, G. J.E., Coert, B., Roos, Y. B.W.E.M.
(2009). Hyperglycemia and Clinical Outcome in Aneurysmal Subarachnoid Hemorrhage: A Meta-Analysis. Stroke
40: e424-e430
[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]
Bratton, S. L.
(2009). Effects of Normalizing Blood Glucose on Outcomes of Intensive Care. AAP Grand Rounds
21: 57-57
[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]
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]
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]
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]
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]
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]
American Diabetes Association,
(2009). Standards of Medical Care in Diabetes--2009. Diabetes Care
32: S13-S61
[Full Text]
Hermans, G., Schetz, M., van den Berghe, G.
(2008). Tight Glucose Control in Critically Ill Adults. JAMA
300: 2725-2725
[Full Text]
Preiser, J.-C., Devos, P.
(2008). Tight Glucose Control in Critically Ill Adults. JAMA
300: 2726-2726
[Full Text]
Scott, M. G., Bruns, D. E., Sacks, D. B.
(2008). Tight Glucose Control in Critically Ill Adults. JAMA
300: 2725-2726
[Full Text]
Bistrian, B. R.
(2008). Tight Glucose Control in Critically Ill Adults. JAMA
300: 2726-2726
[Full Text]
Neumar, R. W., Nolan, J. P., Adrie, C., Aibiki, M., Berg, R. A., Bottiger, B. W., Callaway, C., Clark, R. S.B., Geocadin, R. G., Jauch, E. C., Kern, K. B., Laurent, I., Longstreth, W.T. Jr, Merchant, R. M., Morley, P., Morrison, L. J., Nadkarni, V., Peberdy, M. A., Rivers, E. P., Rodriguez-Nunez, A., Sellke, F. W., Spaulding, C., Sunde, K., Vanden Hoek, T.
(2008). Post-Cardiac Arrest Syndrome: Epidemiology, Pathophysiology, Treatment, and Prognostication A Consensus Statement From the International Liaison Committee on Resuscitation (American Heart Association, Australian and New Zealand Council on Resuscitation, European Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Asia, and the Resuscitation Council of Southern Africa); the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; and the Stroke Council. Circulation
118: 2452-2483
[Full Text]
Buonocore, D.
(2008). Treatment of Hyperglycemia. Crit Care Nurse
28: 72-73
[Full Text]
Kruyt, N D, Roos, Y W B M, Dorhout Mees, S M, van den Bergh, W M, Algra, A, Rinkel, G J E, Biessels, G J
(2008). High mean fasting glucose levels independently predict poor outcome and delayed cerebral ischaemia after aneurysmal subarachnoid haemorrhage. J. Neurol. Neurosurg. Psychiatry
79: 1382-1385
[Abstract][Full Text]
Lameire, N., Van Biesen, W., Hoste, E., Vanholder, R.
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[Abstract][Full Text]
Polito, A., Thiagarajan, R. R., Laussen, P. C., Gauvreau, K., Agus, M. S.D., Scheurer, M. A., Pigula, F. A., Costello, J. M.
(2008). Association Between Intraoperative and Early Postoperative Glucose Levels and Adverse Outcomes After Complex Congenital Heart Surgery. Circulation
118: 2235-2242
[Abstract][Full Text]
Goyal, A., Nerenberg, K., Gerstein, H. C, Umpierrez, G., Wilson, P. W.
(2008). Insulin therapy in acute coronary syndromes: an appraisal of completed and ongoing randomised trials with important clinical end points. Diabetes and Vascular Disease Research
5: 276-284
[Abstract]
Beardsall, K., Vanhaesebrouck, S., Ogilvy-Stuart, A. L., Vanhole, C., Palmer, C. R., van Weissenbruch, M., Midgley, P., Thompson, M., Thio, M., Cornette, L., Ossuetta, I., Iglesias, I., Theyskens, C., de Jong, M., Ahluwalia, J. S., de Zegher, F., Dunger, D. B.
(2008). Early Insulin Therapy in Very-Low-Birth-Weight Infants. NEJM
359: 1873-1884
[Abstract][Full Text]
Kashyap, S., Polin, R. A.
(2008). Insulin Infusions in Very-Low-Birth-Weight Infants. NEJM
359: 1951-1953
[Full Text]
Thompson, J. L., Duffy, J.
(2008). Nutrition Support Challenges in Hematopoietic Stem Cell Transplant Patients. Nutr Clin Pract
23: 533-546
[Abstract][Full Text]
Lansang, M. C., Umpierrez, G. E.
(2008). Management of Inpatient Hyperglycemia in Noncritically Ill Patients. Diabetes Spectr.
21: 248-255
[Abstract][Full Text]
D'Hondt, N. J.
(2008). Continuous Intravenous Insulin: Ready for Prime Time. Diabetes Spectr.
21: 255-261
[Abstract][Full Text]
Howard, R S, Tan, S V, Z'Graggen, W J
(2008). Weakness on the intensive care unit. PN
8: 280-295
[Abstract][Full Text]
Ulate, K. P., Lima Falcao, G. C., Bielefeld, M. R., Morales, J. M., Rotta, A. T.
(2008). Strict Glycemic Targets Need Not Be So Strict: A More Permissive Glycemic Range for Critically Ill Children. Pediatrics
122: e898-e904
[Abstract][Full Text]
Ware, L. B.
(2008). Clinical Year in Review IV: Acute Respiratory Distress Syndrome, Radiology in the Intensive Care Unit, Nonpulmonary Critical Care, and Pulmonary Infections in the Immunocompromised Host. Proc Am Thorac Soc
5: 755-760
[Full Text]
Wiener, R. S., Wiener, D. C., Larson, R. J.
(2008). Benefits and Risks of Tight Glucose Control in Critically Ill Adults: A Meta-analysis. JAMA
300: 933-944
[Abstract][Full Text]
Finfer, S., Delaney, A.
(2008). Tight Glycemic Control in Critically Ill Adults. JAMA
300: 963-965
[Full Text]
Sadhu, A. R., Ang, A. C., Ingram-Drake, L. A., Martinez, D. S., Hsueh, W. A., Ettner, S. L.
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[Abstract][Full Text]
Svendsen, O. S., Liden, A., Nedrebo, T., Rubin, K., Reed, R. K.
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295: H555-H560
[Abstract][Full Text]
Ashare, A., Nymon, A. B., Doerschug, K. C., Morrison, J. M., Monick, M. M., Hunninghake, G. W.
(2008). Insulin-like Growth Factor-1 Improves Survival in Sepsis via Enhanced Hepatic Bacterial Clearance. Am. J. Respir. Crit. Care Med.
178: 149-157
[Abstract][Full Text]
Zmijewski, J. W., Lorne, E., Zhao, X., Tsuruta, Y., Sha, Y., Liu, G., Siegal, G. P., Abraham, E.
(2008). Mitochondrial Respiratory Complex I Regulates Neutrophil Activation and Severity of Lung Injury. Am. J. Respir. Crit. Care Med.
178: 168-179
[Abstract][Full Text]
Albacker, T., Carvalho, G., Schricker, T., Lachapelle, K.
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86: 20-27
[Abstract][Full Text]
Kidd, L. B., Schabbauer, G. A., Luyendyk, J. P., Holscher, T. D., Tilley, R. E., Tencati, M., Mackma, N.
(2008). Insulin Activation of the Phosphatidylinositol 3-Kinase/Protein Kinase B (Akt) Pathway Reduces Lipopolysaccharide-Induced Inflammation in Mice. J. Pharmacol. Exp. Ther.
326: 348-353
[Abstract][Full Text]
Crowley, S. T., Chertow, G. M., Vitale, J., O'Connor, T., Zhang, J., Schein, R. M.H., Choudhury, D., Finkel, K., Vijayan, A., Paganini, E., Palevsky, P. M., for the VA/NIH Acute Renal Failure Trial Network S,
(2008). Lessons for Successful Study Enrollment from the Veterans Affairs/National Institutes of Health Acute Renal Failure Trial Network Study. CJASN
3: 955-961
[Abstract][Full Text]
McCormick, M. T., Muir, K. W., Gray, C. S., Walters, M. R.
(2008). Management of Hyperglycemia in Acute Stroke: How, When, and for Whom?. Stroke
39: 2177-2185
[Full Text]
Stegenga, M. E., van der Crabben, S. N., Blumer, R. M. E., Levi, M., Meijers, J. C. M., Serlie, M. J., Tanck, M. W. T., Sauerwein, H. P., van der Poll, T.
(2008). Hyperglycemia enhances coagulation and reduces neutrophil degranulation, whereas hyperinsulinemia inhibits fibrinolysis during human endotoxemia. Blood
112: 82-89
[Abstract][Full Text]
Rubenfeld, G. D., Angus, D. C.
(2008). Are Intensivists Safe?. ANN INTERN MED
148: 877-879
[Full Text]
Via, M., Scurlock, C., Raikhelkar, J., Luozzo, G. D., Mechanick, J. I.
(2008). Chromium Infusion Reverses Extreme Insulin Resistance in a Cardiothoracic ICU Patient. Nutr Clin Pract
23: 325-328
[Abstract][Full Text]
Ellger, B., Richir, M. C., van Leeuwen, P. A. M., Debaveye, Y., Langouche, L., Vanhorebeek, I., Teerlink, T., Van den Berghe, G.
(2008). Glycemic Control Modulates Arginine and Asymmetrical-Dimethylarginine Levels during Critical Illness by Preserving Dimethylarginine-Dimethylaminohydrolase Activity. Endocrinology
149: 3148-3157
[Abstract][Full Text]
Hirshberg, E., Lacroix, J., Sward, K., Willson, D., Morris, A. H.
(2008). Blood Glucose Control in Critically Ill Adults and Children: A Survey on Stated Practice. Chest
133: 1328-1335
[Abstract][Full Text]
Lacherade, J.-C., Outin, H., De Jonghe, B., Bracco, D., Schricker, T., Carvalho, G., Muller, L., Jaber, S., Lefrant, J. Y., Van den Berghe, G., Wilmer, A., Bouillon, R., Ellger, B., van den Heuvel, I., Poelaert, J., Brunkhorst, F. M., Reinhart, K., Engel, C.
(2008). Insulin and Pentastarch for Severe Sepsis. NEJM
358: 2071-2075
[Full Text]
Saberi, F., Heyland, D., Lam, M., Rapson, D., Jeejeebhoy, K.
(2008). Prevalence, Incidence, and Clinical Resolution of Insulin Resistance in Critically Ill Patients: An Observational Study. JPEN J Parenter Enteral Nutr
32: 227-235
[Abstract][Full Text]
Smith, S. M., Hagg, D. S.
(2008). Glucose Variance in ICU Patients Receiving Insulin Infusions. Chest
133: 1288-1288
[Full Text]
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