Articles: critical-illness.
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Revue médicale de Liège · Dec 2001
Randomized Controlled Trial Clinical Trial[Clinical study of the month. Toxicity of hyperglycemia in intensive care and beneficial effects of optimized insulin therapy].
A large Belgian, prospective, controlled study was performed in 1.548 critically ill patients (83% without history of diabetes) hospitalised in a surgical intensive care unit. On admission, patients were randomly assigned to receive intensive intravenous insulin therapy (maintenance of blood glucose at a level between 80 and 110 mg/dl) or conventional treatment (infusion of insulin only if the blood glucose level exceeded 215 mg/dl and maintenance of glucose at a level between 180 and 200 mg/dl). Intensive insulin therapy reduced morbidity and mortality by 40%. These remarkable results should influence further therapeutical attitudes in intensive care units and open new perspectives for the management of critically ill patients.
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Randomized Controlled Trial Clinical Trial
Intensive insulin therapy in critically ill patients.
Hyperglycemia and insulin resistance are common in critically ill patients, even if they have not previously had diabetes. Whether the normalization of blood glucose levels with insulin therapy improves the prognosis for such patients is not known. ⋯ Intensive insulin therapy to maintain blood glucose at or below 110 mg per deciliter reduces morbidity and mortality among critically ill patients in the surgical intensive care unit.
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Randomized Controlled Trial Clinical Trial
Influence of polymeric enteral nutrition supplemented with different doses of glutamine on gut permeability in critically ill patients.
To evaluate the effect of glutamine-supplemented polymeric enteral formulas on the recovery of gut-permeability abnormalities in critically ill patients. ⋯ Even though polymeric enteral nutrition was associated with a significant improvement in the L/M ratio, glutamine supplementation did not show a specific influence in improving recovery of gut permeability in critically ill patients.
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Jpen Parenter Enter · Nov 2001
Randomized Controlled Trial Multicenter Study Clinical TrialEarly enteral nutrition in critically ill patients with a high-protein diet enriched with arginine, fiber, and antioxidants compared with a standard high-protein diet. The effect on nosocomial infections and outcome.
This study was designed to evaluate the effects of a high-protein formula enriched with arginine, fiber, and antioxidants compared with a standard high-protein formula in early enteral nutrition in critically ill patients. ⋯ Critically ill patients fed a high-protein diet enriched with arginine, fiber, and antioxidants had a significantly lower catheter-related sepsis rate than patients fed a standard high-protein diet. There were no differences in mortality or ICU and hospital length of stay. The subgroup of patients fed the study diet for >2 days showed a trend toward decreased mortality.
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Randomized Controlled Trial Clinical Trial
Intermittent hemodiafiltration in acute renal failure in critically ill patients.
The objective was to study the effects of daily intermittent on-line predilution hemodiafiltration (IHDF) on laboratory parameters, and on multiple organ dysfunction score (MODS), compared with intermittent hemodialysis (IHD). ⋯ This study demonstrated equal control of azotemia, acidosis, and calcium-phosphate balance in both treatment groups with no treatment-specific complications of IHDF.