Intensive insulin therapy in high-risk cardiac surgery patients: evidence from the Leuven randomized study.

Full Abstract

Mortality and morbidity of critically ill diabetic as well as nondiabetic patients are improved when blood glucose levels are tightly controlled to normoglycemia with intensive insulin therapy during their stay in the intensive care unit (ICU). This has been demonstrated in large prospective, randomized, controlled clinical studies for adult patients admitted to surgical and medical ICUs. Particularly for cardiac surgery patients, the hospital survival benefit with insulin therapy is most pronounced and maintained up to 4 years after hospital discharge, without inducing a substantial burden for the patients, their relatives, or society. Mechanistic studies exploring the molecular pathways involved suggest that intensive insulin therapy exerts its beneficial effects mainly through the maintenance of normal blood glucose levels.

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Author information

Author/s: Vanhorebeek, Ilse (I); Ingels, Catherine (C); Van den Berghe, Greet (G);

Affiliation: Department of Intensive Care Medicine, Katholieke Universiteit Leuven, Leuven, Belgium.

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't; Review

Journal: Seminars in thoracic and cardiovascular surgery (Semin Thorac Cardiovasc Surg), published in United States. (Language: eng)

Reference: 2006-; vol 18 (issue 4) : pp 309-16

Dates: Created 2007/03/30; Completed 2007/06/29; Revised 2007/11/15;

PMID: 17395027, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Blood Glucose - drug effects; metabolism
Cardiac Surgical Procedures
Critical Illness
Heart Diseases - epidemiology; surgery
Hospital Mortality
Humans

Hyperglycemia - drug therapy; epidemiology
Hypoglycemic Agents - therapeutic use
Insulin - therapeutic use
Postoperative Period
Randomized Controlled Trials as Topic
Risk Factors

Associated Chemicals: Blood Glucose (0) ; Hypoglycemic Agents (0) ; Insulin (11061-68-0)

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