How to compare adequacy of algorithms to control blood glucose in the intensive care unit?

被引:12
作者
Van den Berghe, G [1 ]
机构
[1] Catholic Univ Leuven, Dept Intens Care Med, Louvain, Belgium
来源
CRITICAL CARE | 2004年 / 8卷 / 03期
关键词
algorithm; glucose; insulin; intensive care; mortality;
D O I
10.1186/cc2856
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Vogelzang et al. retrospectively assessed a derivative marker of blood glucose control over time in the intensive care unit (ICU), "the hyperglycemic index" (HGI), in relation to outcome. The HGI predicted mortality better than other indices of blood glucose control that do not take the duration of hyperglycemia into account. This provided further support to the concept of maintaining normoglycemia with insulin throughout intensive care in order to improve outcome. The HGI was also proposed as a tool to assess performance of glucose control algorithms. This, however, implies similar sampling frequency for the compared algorithms. Just as we prefer continuous, online display of blood pressure and/or cardiac output for optimal titration of inotropes and vasopressors, a continuous display of blood glucose levels is mandatory for optimal titration of insulin therapy in ICU. We anxiously await the development and validation of such devices.
引用
收藏
页码:151 / 152
页数:2
相关论文
共 8 条
[1]   Persistent poststroke hyperglycemia is independently associated with infarct expansion and worse clinical outcome [J].
Baird, TA ;
Parsons, MW ;
Phanh, T ;
Butcher, KS ;
Desmond, PM ;
Tress, BM ;
Colman, PG ;
Chambers, BR ;
Davis, SM .
STROKE, 2003, 34 (09) :2208-2214
[2]   Stress hyperglycaemia and increased risk of death after myocardial infarction in patients with and without diabetes: a systematic overview [J].
Capes, SE ;
Hunt, D ;
Malmberg, K ;
Gerstein, HC .
LANCET, 2000, 355 (9206) :773-778
[3]   Glucose control and mortality in critically ill patients [J].
Finney, SJ ;
Zekveld, C ;
Elia, A ;
Evans, TW .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2003, 290 (15) :2041-2047
[4]   Association between hyperglycemia and increased hospital mortality in a heterogeneous population of critically ill patients [J].
Krinsley, JS .
MAYO CLINIC PROCEEDINGS, 2003, 78 (12) :1471-1478
[5]   Regulation of insulin-like growth factor binding protein-1 during protracted critical illness [J].
Mesotten, D ;
Delhanty, PJD ;
Vanderhoydonc, F ;
Hardman, KV ;
Weekers, F ;
Baxter, RC ;
Van den Berghe, G .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2002, 87 (12) :5516-5523
[6]   Outcome benefit of intensive insulin therapy in the critically ill: Insulin dose versus glycemic control [J].
Van den Berghe, G ;
Wouters, PJ ;
Bouillon, R ;
Weekers, F ;
Verwaest, C ;
Schetz, M ;
Vlasselaers, D ;
Ferdinande, P ;
Lamers, P .
CRITICAL CARE MEDICINE, 2003, 31 (02) :359-366
[7]   Intensive insulin therapy in critically ill patients. [J].
Van den Berghe, G ;
Wouters, P ;
Weekers, F ;
Verwaest, C ;
Bruyninckx, F ;
Schetz, M ;
Vlasselaers, D ;
Ferdinande, P ;
Lauwers, P ;
Bouillon, R .
NEW ENGLAND JOURNAL OF MEDICINE, 2001, 345 (19) :1359-1367
[8]   Hyperglycaemic index as a tool to assess glucose control: a retrospective study [J].
Vogelzang, M ;
van der Horst, ICC ;
Nijsten, MWN .
CRITICAL CARE, 2004, 8 (03) :R122-R127