Tight glycemic control what do we really know, and what should we expect 英文参考文献.docVIP

Nasraway Jr and Rattan Critical Care 2010,14:198 /content/14/5/198 COMMENTARY Tight glycemic control: what do we really know, and what should we expect? Stanley A Nasraway Jr* and Rishi Rattan See related research by Chase et al., /content/14/4/R154 e Leuven I study unleashed a torrent of skepticism, Abstract excitement and investigation into tight glycemic control Tight glycemic control has engendered large numbers of investigations, with con?icting results. The world has largely embraced intensive insulin as a practice, but applies this therapy with great variability in the manner of glucose control and measurement. The present commentary reviews what we actually know with certainty from this vast sea of literature, and what we can expect looking forward. [2]. Google searches for ‘tight glycemic control’ and ‘intensive insulin’ produce 80,900 and 334,000 results, respectively. After entering a new decade, where are we? ere is a great deal that we do not know, in part because this ? eld of discovery has been disadvantaged by inconsistencies in research methodology. Among di? er- ences in the studies are case-type selection, targeted ranges of blood glucose, inconsistency in the frequency of blood glucose monitoring, variability in the accuracy of glucometer devices used, variability in the methods In the previous issue of Critical Care, Chase and used to de? ne euglycemia, whether insulin dosing was colleagues present retrospective, historically controlled driven by paper protocol or software algorithm, and data from 784 critically ill patients treated with tight glycemic control (target glucose, 4 to 6 mmol/l) using the nonstandardization in caloric intake. Starting with the Leuven I trial, all of the prospective Specialised Relative Insulin and Nutrition Titration studies conducted to date are vulnerable to signi? cant (