Matches in SemOpenAlex for { <https://semopenalex.org/work/W1489726064> ?p ?o ?g. }
Showing items 1 to 69 of
69
with 100 items per page.
- W1489726064 endingPage "111" @default.
- W1489726064 startingPage "106" @default.
- W1489726064 abstract "The risk of mortality or significant morbidity is high among critically ill patients who are treated in the intensive care unit (ICU) for more than 5 days. These patients are susceptible to sepsis, excessive inflammation, critical illness polyneuropathy and multiple organ failure, the latter often being the cause of death. Most intensive care patients, even those who did not previously suffer from diabetes, are hyperglycemic. This is presumed to reflect an adaptive development of insulin resistance. We hypothesized that hyperglycemia is not a beneficial adaptation to severe illness but rather predisposes patients to many of the typical intensive care complications, prolonged intensive care dependence and death. The effects of intensive insulin therapy to maintain normoglycemia during critical illness were studied in a large group (N=1548) of ventilated, surgical ICU patients. An algorithm was proposed for implementing this procedure. The randomly assigned intensive insulin therapy group received insulin infusion tailored to control blood glucose levels in the range 80–110 mg/dl, whereas the conventional-treatment group only received insulin when glucose levels exceeded 200 mg/dl and in that event were maintained in a target range of 180–200 mg/dl. Intensive insulin therapy induced a 43% reduction of intensive care mortality risk (p = 0.036 after correction for interim analyses) and a 34% reduction of hospital mortality (p = 0.005). A reduced risk of severe infections by 46% (p = 0.003) was associated with a 35% reduction in prolonged (> 10 d) requirement for antibiotic therapy (p < 0.001). In addition, excessive inflammation was prevented. Logistic regression analysis indicated that control of blood glucose levels, rather than insulin administration itself, likely explains the observed clinical benefits. In conclusion, use of insulin infusion to maintain normoglycemia using a titration algorithm, at least in populations similar to those in our study, improves outcome. Further data are needed to establish the applicability of this strategy to other patient groups, such as those in the medical ICU and in general hospital care." @default.
- W1489726064 created "2016-06-24" @default.
- W1489726064 creator A5015014169 @default.
- W1489726064 date "2003-04-01" @default.
- W1489726064 modified "2023-09-26" @default.
- W1489726064 title "Intensive insulin therapy in the ICU" @default.
- W1489726064 hasPublicationYear "2003" @default.
- W1489726064 type Work @default.
- W1489726064 sameAs 1489726064 @default.
- W1489726064 citedByCount "0" @default.
- W1489726064 crossrefType "journal-article" @default.
- W1489726064 hasAuthorship W1489726064A5015014169 @default.
- W1489726064 hasConcept C126322002 @default.
- W1489726064 hasConcept C134018914 @default.
- W1489726064 hasConcept C177713679 @default.
- W1489726064 hasConcept C2776376669 @default.
- W1489726064 hasConcept C2777391703 @default.
- W1489726064 hasConcept C2777698862 @default.
- W1489726064 hasConcept C2778384902 @default.
- W1489726064 hasConcept C2779306644 @default.
- W1489726064 hasConcept C2987404301 @default.
- W1489726064 hasConcept C2991859549 @default.
- W1489726064 hasConcept C2993568657 @default.
- W1489726064 hasConcept C555293320 @default.
- W1489726064 hasConcept C71924100 @default.
- W1489726064 hasConceptScore W1489726064C126322002 @default.
- W1489726064 hasConceptScore W1489726064C134018914 @default.
- W1489726064 hasConceptScore W1489726064C177713679 @default.
- W1489726064 hasConceptScore W1489726064C2776376669 @default.
- W1489726064 hasConceptScore W1489726064C2777391703 @default.
- W1489726064 hasConceptScore W1489726064C2777698862 @default.
- W1489726064 hasConceptScore W1489726064C2778384902 @default.
- W1489726064 hasConceptScore W1489726064C2779306644 @default.
- W1489726064 hasConceptScore W1489726064C2987404301 @default.
- W1489726064 hasConceptScore W1489726064C2991859549 @default.
- W1489726064 hasConceptScore W1489726064C2993568657 @default.
- W1489726064 hasConceptScore W1489726064C555293320 @default.
- W1489726064 hasConceptScore W1489726064C71924100 @default.
- W1489726064 hasIssue "2" @default.
- W1489726064 hasLocation W14897260641 @default.
- W1489726064 hasOpenAccess W1489726064 @default.
- W1489726064 hasPrimaryLocation W14897260641 @default.
- W1489726064 hasRelatedWork W1975939299 @default.
- W1489726064 hasRelatedWork W1986607710 @default.
- W1489726064 hasRelatedWork W2075045278 @default.
- W1489726064 hasRelatedWork W2084483744 @default.
- W1489726064 hasRelatedWork W2114510449 @default.
- W1489726064 hasRelatedWork W2115285670 @default.
- W1489726064 hasRelatedWork W2123811242 @default.
- W1489726064 hasRelatedWork W2134369433 @default.
- W1489726064 hasRelatedWork W2145053281 @default.
- W1489726064 hasRelatedWork W2176987225 @default.
- W1489726064 hasRelatedWork W2274076556 @default.
- W1489726064 hasRelatedWork W2357534471 @default.
- W1489726064 hasRelatedWork W2362301020 @default.
- W1489726064 hasRelatedWork W2374950123 @default.
- W1489726064 hasRelatedWork W2387603927 @default.
- W1489726064 hasRelatedWork W2388486117 @default.
- W1489726064 hasRelatedWork W2391293828 @default.
- W1489726064 hasRelatedWork W2915508777 @default.
- W1489726064 hasRelatedWork W3092825957 @default.
- W1489726064 hasRelatedWork W3021720148 @default.
- W1489726064 hasVolume "7" @default.
- W1489726064 isParatext "false" @default.
- W1489726064 isRetracted "false" @default.
- W1489726064 magId "1489726064" @default.
- W1489726064 workType "article" @default.