This article investigates the effects of tight blood-glucose control versus liberal glucose control in critically ill patients who are not receiving early parenteral nutrition. The study randomly assigned patients into two groups: one receiving tight glucose control, targeting blood-glucose levels between 80 to 110 mg per deciliter, and the other receiving liberal glucose control, initiating insulin only when blood-glucose levels exceeded 215 mg per deciliter. The primary outcomes measured were the length of ICU stay and mortality at 90 days. The study concluded that tight glucose control did not significantly impact the duration of ICU care or mortality rates but was associated with fewer instances of severe acute kidney injury and cholestatic liver dysfunction.
Learning Outcomesย
Upon completion of this activity, you should have an understanding of:
The effects of tight versus liberal glucose control in ICU patients: Learners will understand the impact of different glucose control strategies on patient outcomes, particularly regarding ICU stay duration and mortality.
Complications related to glucose management in critically ill patients: Learners will comprehend how tight glucose control may reduce the prevalence of acute kidney injury and liver dysfunction in ICU patients.
The role of computer algorithms in managing blood glucose levels: Learners will explore how the use of the LOGIC-Insulin algorithm helps avoid iatrogenic hypoglycemia, providing a safer approach to blood glucose management in ICU settings.
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What was the primary outcome measured in this trial comparing tight and liberal glucose control in critically ill patients?
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pg 1
Question 2 of 15
2. Question
Which blood glucose range was targeted in the tight glucose control group?
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pg 1
Question 3 of 15
3. Question
True or False: Tight glucose control reduced the length of ICU stay in critically ill patients.
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pg 1
Question 4 of 15
4. Question
What was the insulin initiation threshold in the liberal glucose control group?
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pg 2
Question 5 of 15
5. Question
True or False: Patients receiving tight glucose control had a lower incidence of severe hypoglycemia compared to those in the liberal glucose control group.
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pg 2
Question 6 of 15
6. Question
What percentage of patients in the liberal control group experienced severe hypoglycemia?
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pg 2
Question 7 of 15
7. Question
Which of the following secondary outcomes was significantly different between the tight and liberal glucose control groups?
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pg 3
Question 8 of 15
8. Question
What percentage of patients in the tight glucose control group developed severe acute kidney injury?
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pg 3
Question 9 of 15
9. Question
True or False: Mortality at 90 days was significantly lower in the tight glucose control group compared to the liberal glucose control group.
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pg 2
Question 10 of 15
10. Question
What effect did tight glucose control have on the incidence of new infections?
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pg 3
Question 11 of 15
11. Question
Which of the following was one of the main benefits observed with tight glucose control?
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pg 3
Question 12 of 15
12. Question
What percentage of patients in the tight glucose control group required kidney-replacement therapy?
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pg 3
Question 13 of 15
13. Question
What type of nutrition was withheld from both groups during the first week in the ICU?
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pg 1
Question 14 of 15
14. Question
Which subgroup might benefit from tight glucose control according to the findings?
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pg 4
Question 15 of 15
15. Question
In this trial what was the median morning blood-glucose level achieved in the tight glucose control group?