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Treatment of Blood Sugar
Levels in Intensive Care Patients Reduces Mortality 29%
posted August 19, 2004
A low-cost, effective intervention
that can profoundly affect patients and will eventually become a standard of
care in ICUs (intensive care units) worldwide.
James Krinsley, M.D., the author of the study, is director of critical care at
The Stamford Hospital in Stamford, Conn., Dr. Krinsley says conducting the study
in a community hospital should give other hospitals confidence that they can
maintain the necessary level of glucose monitoring and treatment without being a
large-scale research hospital.
Dr. Krinsley analyzed 800 consecutive patients admitted to the unit just prior
to institution of the glucose management protocol and compared them to the first
800 consecutive patients admitted after the protocol was put into place. The
protocol involved intensive monitoring of the glucose levels in patients and
treating any elevation over 140 milligrams per deciliter (mg/dL) with injections
of insulin under the skin or continuous intravenous insulin infusions, depending
on the level of elevation.
The hospital mortality rate of the treated patients decreased 29.3 percent. This
represents 49 saved lives from the first 800 patients treated with the protocol.
There was also a decrease in the development of new kidney failure and a
decrease in the need for red blood cell transfusions. The ICU length of stay
decreased among the patients treated with the protocol.
The current study from Stamford Hospital is the first to show that intensive
glucose management can improve survival among a general population of critically
ill patients, similar to the patients found in the majority of ICUs around the
world.
The standard of care in ICUs until recently was to accept moderate elevations of
glucose, even up to 200-225 mg/dL, without using insulin treatment, says Dr.
Krinsley. The current study will help to change that paradigm, he says.
Source: Diabetes In Control.com: Mayo Clinic Proceedings August 2004.
August 2004 News Article Index
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