Thursday, 10 January 2008

Intensive Insulin Therapy: no benefit in severe sepsis

In recent years there has been much interest about the survival benefit from tight glucose control in critically ill patients. This large RCT, published in the NEJM, evaluated the effect of intensive insulin therapy and pentastarch 10% for fluid resusciation (v Ringers lactate solution) in patients with severe sepsis. The study was halted early due to safety. Overall there was no survival benefit. The rate of severe hypoglycaemia was 17% in the insulin group. Pentastach was associated with renal failure compared with Ringers lactate solution.

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