Glucose–insulin–potassium infusion in sepsis and septic shock: no hard evidence yet
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* Corresponding author: Iwan CC van der Horst iwanouk@hotmail.com
1 Resident, Department of Cardiology, Isala Clinics, location Weezenlanden, Zwolle, The Netherlands
2 Internist-Endocrinologist, Intensive & Respiratory Care Unit of the Department of Internal Medicine, University Hospital Groningen, Groningen, The Netherlands
3 Internist-Nephrologist, Department of Internal Medicine, Isala Clinics, location Weezenland, Zwolle, The Netherlands
4 Cardiologist, Department of Cardiology, Isala Clinics, location Weezenlanden, Zwolle, The Netherlands
5 Professor, Department of Internal Medicine, University Hospital Groningen, Groningen, The Netherlands
Critical Care 2003, 7:13-15 doi:10.1186/cc1832
Published: 9 October 2002Abstract
There is no hard evidence yet for a positive effect of glucose–insulin–potassium infusion in sepsis, septic shock or burn patients. Each individual element of the glucose–insulin–potassium regimen, and eventually euglycaemia, should theoretically be beneficial. At present, evidence exists only for reduced mortality with strict metabolic treatment (i.e. blood glucose levels of 4.4–6.1 mmol/l) in critically ill patients admitted to surgical intensive care units, and for better metabolic regulation (i.e. blood glucose levels of 7.0–10.0 mmol/l) in patients with hyperglycaemia and/or diabetes mellitus, and in patients without signs of heart failure (i.e. Killip class I) during acute myocardial infarction.