Clinical study of intensive insulin therapy in critically ill patients

Objective To study the effect of intensive insulin therapy in critically ill patients.Methods Ninety-six critically ill patients without diabetes participated in the study.These patients stayed in intensive care unit(ICU) for at least two days.The blood glucose of these patients was(14.6±5.5) mmol/L when they entered ICU.The patients were randomly divided into treatment group(n=48) and control group(n=48).Treatment group received intensive insulin therapy,whose blood glucose was controlled at 4.4-6.1 mmol/L.While the control group received routine insulin therapy,whose blood glucose was controlled at 8.3-11.1 mmol/L.Some parameters as follows were observed: the days of using antibiotics,the use of pressor agent,the number of patients requiring mechanical ventilation,the days of mechanical ventilation,incidence rate of nosocomial infection,incidence rate of stress ulcer,morbidity of hypoglycemia,morbidity of multiple organ failure(MOF),Acute Physiology and Chronic Health Evaluation(APACHE)Ⅱ score of the last day in ICU,total days in ICU and mortality.Results Except the morbidity of hypoglycemia was significantly higher in treatment group than that in control group(P0.05),other parameters such as the days of using antibiotics,the use of pressor agent,the number of patients requiring mechanical ventilation,the days of mechanical ventilation,incidence rate of nosocomial infection,incidence rate of stress ulcer,morbidity of MOF,APACHEⅡ score of the last day in ICU,total days in ICU and mortality were lower in treatment group than those in control group.Conclusion Intensive insulin therapy,keeping blood glucose 4.4-6.1 mmol/L,improves the critically ill patients' condition and reduces the mortality.