Tight glycaemic control in the intensive care unit pitfalls in the testing of the concept 英文参考文献.docVIP
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Tight glycaemic control in the intensive care unit pitfalls in the testing of the concept 英文参考文献
Available online /content/12/5/187
Commentary
Tight glycaemic control in the intensive care unit: pitfalls in the
testing of the concept
Dieter Mesotten
Department of Intensive Care Medicine, Catholic University of Leuven, University Hospital Leuven, Herestraat 49, B-3000 Leuven, Belgium
Corresponding author: Dieter Mesotten, dieter.mesotten@med.kuleuven.be
Published: 24 October 2008
Critical Care 2008, 12:187 (doi:10.1186/cc7086)
This article is online at /content/12/5/187
? 2008 BioMed Central Ltd
See related research by De La Rosa et al., /content/12/5/R120
Abstract
over implementation studies, which showed a benefit of tight
glycaemic control but are substandard to assess effective-
ness of a therapy [4]. The overall methodological quality was
adequate with regard to randomisation, allocation conceal-
ment, intention-to-treat analysis, and completeness of follow-
up. The slight differences in study population, such as the
proportion of patients post-cardiac surgery and the on-
admission APACHE (Acute Physiology and Chronic Health
Evaluation) II score, are probably of minor importance. The
pitfalls that matter may hide beneath the surface.
Tight glycaemic control emerged on the scene of critical care in
Surprisingly, not many confirmation trials have been
published so far. The randomised controlled trial by De La Rosa
and colleagues is a timely and valuable attempt to repeat the
landmark Leuven studies. The failure to replicate the beneficial
effects of tight glycaemic control may boil down to some less
obvious defaults in the set-up of the trial despite a seemingly
2001.
adequate
study design. The incorporation of ample power
calculations and strict adherence to glucose targets are essential
to fairly compare studies on tight blood glucose control. Only if
these basic conditions of study design are fulfilled
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