Differential temporal profile of lowered blood glucose levels (3.5 to 6.5 mmoll versus 5 to 8 mmoll) in patients with severe traumatic brain injury.docVIP

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Differential temporal profile of lowered blood glucose levels (3.5 to 6.5 mmoll versus 5 to 8 mmoll) in patients with severe traumatic brain injury.doc

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Differential temporal profile of lowered blood glucose levels (3.5 to 6.5 mmoll versus 5 to 8 mmoll) in patients with severe traumatic brain injury

Available online /content/12/4/R98 Research Open Access Vol 12 No 4 Differential temporal profile of lowered blood glucose levels (3.5 to 6.5 mmol/l versus 5 to 8 mmol/l) in patients with severe traumatic brain injury Regula Meier1, Markus Béchir1, Silke Ludwig1, Jutta Sommerfeld1, Marius Keel2, Peter Steiger1, Reto Stocker1 and John F Stover1 1Surgical Intensive Care Medicine, University Hospital Zuerich, Raemistrasse 100, CH 8091 Zuerich, Switzerland 2Department of Surgery, Division of Trauma Surgery, University Hospital Zuerich, Raemistrasse 100, CH 8091 Zuerich, Switzerland Corresponding author: John F Stover, john.stover@access.unizh.ch Received: 28 May 2008 Revisions requested: 23 Jun 2008 Revisions received: 14 Jul 2008 Accepted: 4 Aug 2008 Published: 4 Aug 2008 Critical Care 2008, 12:R98 (doi:10.1186/cc6974) This article is online at: /content/12/4/R98 ? 2008 2008 Meier et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Introduction Hyperglycaemia is detrimental, but maintaining low blood glucose levels within tight limits is controversial in patients with severe traumatic brain injury, because decreased blood glucose levels can induce and aggravate underlying brain injury. 3. 5 to 6.5 mmol/l group, predominantly during the first week. Insulin and norepinephrine requirements were markedly increased in this group. During the second week, the incidences of intracranial pressure exceeding 20 mmHg and infectious complications were significantly decreased in the 3.5 to 6.5 mmol/l group. Methods In 228 propensity matched patients (age, sex and injury severity) treated in our intensive care unit (ICU) from 2000 to 2004, we retrospectively evaluated the influence of differen