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Single centre randomised controlled trial, stratified by diagnostic category and age, comparing conventional or intensive insulin treatment.
Concealed allocation by envelopes.
Blinding not stated.
Paediatric intensive care unit (PICU) in a Belgian University hospital.
700 critically ill children, 317 infants <1 year and 383 children >1 year.
(1) Conventional group, insulin infusion commenced for blood glucose concentration >11.9 mmol/l twice and dose adjusted to maintain blood glucose 10.0–11.9 mmol/l. (2) Intensive insulin group, insulin infused at 0.1 U/kg/h to target age-adjusted normoglycaemia: for infants aged 0–1 year 2.8–4.4 mmol/l and for children aged 1–16 years 3.9–5.5 mmol/l. If hypoglycaemic, then infusion stopped and 50% dextrose given.
|Conventional (n=351)||Intensive (n=349)||ARR/ARI (95% CI)|
|Paediatric intensive care unit mortality (30 days)||5.7%||2.6%||3.1% (0.2% to 6.1%)|
|Days in ICU (mean, 95% CI)||6.15 (5.25 to 7.05)||5.51 (4.65 to 6.37)|
|Number of secondary infections||129 (36.8%)||102 (29.2%)||7.5% (0.6% to 14.5%)|
|Number of patients with hypoglycaemia||5 (1.4%)||87 (24.9%)||23.5% (18.8% to 28.2%)|
In-hospital morbidity, PICU mortality and length of stay. C-reactive protein, duration of mechanical ventilation and vital organ support and markers of organ dysfunction were also recorded. Adverse events included hypoglycaemic episodes.
Until PICU discharge.
Insulin therapy was administered in …
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