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Therapeutics
Randomised controlled trial
Tight glycaemic control does not improve mortality or morbidity in critically ill children
  1. Sarah B Kandil,
  2. Edward Vincent S Faustino
  1. Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, USA
  1. Correspondence to: Dr Edward Vincent S Faustino, Department of Pediatrics, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA; vince.faustino{at}yale.edu

https://doi.org/10.1136/eb-2014-101749

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    Commentary on: Macrae D, Grieve R, Allen E, et al. A randomized trial of hyperglycemic control in pediatric intensive care. N Engl J Med 2014;370:107–18.OpenUrlCrossRefPubMedWeb of Science

    Context

    With tight glycaemic control (TGC), blood glucose is maintained at normal fasting levels with intravenous insulin. The efficacy and safety of TGC in critically ill patients is unclear. One study showed that TGC in the surgical intensive care unit reduced mortality and organ failure in critically ill adults1; however, subsequent trials failed to replicate these results. In fact, one multicentre trial showed higher mortality in critically ill adults undergoing TGC. Hypoglycaemia was more common with TGC.2 Macrae and colleagues …

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    Footnotes

    • Competing interests SBK and EVSF are site investigators for the Heart and Lung Failure—Pediatric Insulin Titration Trial (National Clinical Trials #01565941).