Restoring normoglycaemia not so harmless 英文参考文献.docVIP

Available online /content/12/1/116 Commentary Restoring normoglycaemia: not so harmless Jean-Charles Preiser Department of General Intensive Care, University Hospital Centre, University of Liege, Domaine Universitaire du Sart Tilman – B 35, 4000 Liege, Belgium Corresponding author: Jean-Charles Preiser, Jean-Charles.Preiser@chu.ulg.ac.be Published: 28 February 2008 Critical Care 2008, 12:116 (doi:10.1186/cc6787) This article is online at /content/12/1/116 ? 2008 BioMed Central Ltd Abstract risk for heart attack and stroke followed in 77 North American centres [5]. The Action to Control Cardiovascular Risk in Diabetes (ACCORD) study was halted prematurely, however, because of an excess mortality in the intensive treatment arm. The sustained lowering of blood glucose was Three independent studies of tight glucose control were recently stopped prematurely due to an excess mortality in the intensive treatment arm. This commentary briefly discusses the potential mechanisms and reminds the potential benefits of physiological stress hyperglycemia. reflected by a fall below 6% of the percentage of glycosylated haemoglobin in the intensive treatment group, as planned per protocol. In the closed world of intensive care medicine, the wave of enthusiasm triggered by the Leuven study [1] – which reported a dramatic improvement in the vital outcome of surgical intensive care unit patients after restoration of normoglycaemia by intensive insulin therapy – progressively vanished after the failure of several trials conducted to confirm these results in other institutions or settings. Even though short-term and long-term mortality can hardly be integrated, these three major studies provide a consistent sound alarm signal against the concept of lowering blood glucose as a simple risk-free, harmless