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Updated: May 2, 2026
12:08
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
19.7K
[Insulin infusion in intensive care: randomized controlled trial].
Milena Penteado Ferraro Miranda1, Jeiel Carlos Lamonica Crespo2, Silvia Regina Secoli3
1Enfermeira. Especialista em Enfermagem em Terapia Intensiva. Mestre pelo Programa de Pós-Gradua,o em Enfermagem na Saúde do Adulto da Escola de Enfermagem da Universidade de São Paulo. São Paulo, SP, Brasil. enfi_mi@yahoo.com.br
Revista Da Escola De Enfermagem Da U S P
|March 8, 2014
Summary
Intensive insulin therapy for severe sepsis and septic shock patients achieved target blood glucose levels. While not reducing mortality, it lessened hemodynamic instability compared to conventional methods.
Area of Science:
- Critical Care Medicine
- Endocrinology
- Internal Medicine
Context:
- Severe sepsis and septic shock are life-threatening conditions requiring intensive management.
- Glycemic control is a key aspect of critical care for these patients.
- Previous research on insulin protocols in critical illness has yielded varied results.
Purpose:
- To compare the clinical outcomes of intensive versus conventional insulin protocols in patients with severe sepsis and septic shock within the initial 72 hours.
- To evaluate the impact of strict glycemic control (80-110 mg/dL) versus a broader range (180-220 mg/dL) on patient outcomes.
Summary:
- A randomized controlled trial involving 46 patients with severe sepsis/septic shock compared intensive (80-110 mg/dL) and conventional (180-220 mg/dL) glycemic control.
- A statistically significant difference in mean glycemia was achieved (p<0.001).
- No significant differences were observed in mean arterial pressure, serum creatinine, or mortality between the groups (p>0.05).
Impact:
- Intensive glycemic control, while not directly reducing mortality, was associated with shorter duration of hemodynamic instability.
- The findings suggest that while strict glucose targets may not alter overall survival, they could improve hemodynamic stability in sepsis patients.
- Further research is warranted to explore the nuanced effects of glycemic control on sepsis pathophysiology and clinical outcomes.
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