8. Tight Blood-Glucose Control without Early Parenteral Nutrition in the ICU

Tight Blood-Glucose Control without Early Parenteral Nutrition in the ICU

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Average read time: 40-50 minutes

Short Summary of the Article:

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 Outcomes 

Upon completion of this activity, you should have an understanding of:

1. 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.
2. 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.
3. 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.