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Commentary

Is it time for implementation of tight glycaemia control by intensive insulin therapy in every ICU?

Philippe Devos and Jean-Charles Preiser*

Author Affiliations

Department of General Intensive Care, University Hospital Centre, University of Liege, Domaine universitaire du Sart-Tilman, B-4000 Liege, Belgium

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Critical Care 2006, 10:130  doi:10.1186/cc4871

Published: 21 March 2006

Abstract

The second study on tight glycaemia control by intensive insulin therapy (IIT) confirmed in medical intensive care unit patients the decrease in hospital mortality reported by the same team in the first IIT trial in surgical patients. However, methodological concerns, the high rate of hypoglycaemia in spite of the infusion of large doses of parenteral glucose and the frequent use of steroids presently preclude considering these results as recommendations in other intensive care units, but rather argue for the need for large-scale assessment of the IIT approach by multi-centre studies to confirm the efficacy and safety of this therapeutic modality.