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Intensive insulin therapy-reduced mortality in patients in paediatric intensive care

https://doi.org/10.1136/adc.2010.189183

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    Study design

    Design

    Single centre randomised controlled trial, stratified by diagnostic category and age, comparing conventional or intensive insulin treatment.

    Allocation

    Concealed allocation by envelopes.

    Blinding

    Blinding not stated.

    Study question

    Setting

    Paediatric intensive care unit (PICU) in a Belgian University hospital.

    Patients

    700 critically ill children, 317 infants <1 year and 383 children >1 year.

    Intervention

    (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.

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    Outcomes

    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.

    Follow-up period

    Until PICU discharge.

    Main results

    Insulin therapy was administered in …

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    Footnotes

    • Sources of funding Research Foundation, Flanders, Belgium; the Research Fund of the University of Leuven, the EU Information Society Technologies Integrated Project and the Institute for Science and Technology, Flanders, Belgium.

    Footnotes

    • Provenance and peer review Commissioned; internally peer reviewed.