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Does Intensive Insulin Therapy Reduce the Severity of Organ Failures?

Authors
Publication Date
Keywords
  • Organ Failure
  • Sofa Score
  • Glycemic Control
  • Glycemic Variability
  • Engineering
  • Computing & Technology :: Multidisciplinary
  • General & Others [C99]
  • Ingénierie
  • Informatique & Technologie :: Multidisciplinaire
  • Généralités & Autres [C99]
Disciplines
  • Medicine

Abstract

Présentation PowerPoint Does Intensive Insulin Therapy Reduce The Severity of Organ Failures? Sophie Penning, MSc; Jean-Charles Preiser, MD, PhD; Thomas Desaive, PhD; J. Geoffrey Chase, PhD University of Liege, Cardiovascular Research Center, Liege, Belgium Centre for Bio-Engineering, University of Canterbury, Christchurch, New Zealand Organ failure is a common complication associated with increased mortality in intensive care unit (ICU) patients. Increased mortality is also associated with hyperglycemia and glycemic variability. This research evaluates the impact of an intensive vs. a conventional insulin therapy (IIT vs. CIT) on organ failures. Objective Method Results IIT was unable to mitigate organ failure in two cohorts randomized to different glycemic targets. IIT provided better but not tighter control, with higher variability and more hypoglycemia than CIT. Conclusion Sophie Penning: [email protected] Contact • Similar SOFA scores • Different BG levels for IIT and CIT. • More BG < 2.2 mmol/L for IIT (54 vs. 15 for CIT) • Higher glycemic variability for IIT but also higher measurement frequency • CIT associated with better 𝑃(𝑆𝑂𝐹𝐴 ≤ 5) and IIT is associated with better 𝑃(𝑐𝑇𝐼𝐵 ≥ 0.5) • Both ITs associated with better SOFA results when good glycemic outcome compared with bad glycemic outcome Results are expressed as median [Inter-Quartile Range] IIT BG target : 4.4-6.1 mmol/L CIT BG target : 7.8-10.0 mmol/L p-value SOFA data Initial SOFA 5.0 [3.0 - 7.0] 5.0 [3.0 - 7.0] 0.65 Maximum SOFA 6.0 [4.0 - 8.0] 6.0 [4.0 - 8.0] 0.40 Per-patient median SOFA 4.0 [3.0 – 6.0] 4.0 [3.0 – 6.0] 0.93 BG data (mmol/L) Initial BG 7.3 [5.9 – 9.5] 7.2 [5.7 – 9.8] 0.48 Minimum BG 3.7 [3.0 - 4.3] 5.1 [4.2 - 5.8] 0.00 Maximum BG 11.1 [8.8 - 13.4] 11.3 [9.6 - 14.2] 0.06 Per-patient median BG 6.3 [5.8 – 6.9] 8.0 [7.

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