OBJECTIVE To evaluate the clinical outcomes of glycemic control of intensive insulin therapy and recommend its place in the management of critically ill patients. DATA SOURCES Searches of MEDLINE (1966-March 2004) and Cochrane Library, as well as an extensive manual review of abstracts were performed using the key search terms hyperglycemia, insulin, intensive care unit, critically ill, outco...

1Department of Anesthesiology and Intensive Care Medicine, Northern State Medical University, Troitsky Avenue 51, Arkhangelsk 163000, Russia 2Department of Anesthesiology, University Hospital of North Norway, Tromsø, Norway 3Anesthesia and Critical Care Research Group, Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, 9037 Tromsø, Norway 4Department of Anaesthes...

BACKGROUND The Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial in 2368 patients with stable ischemic heart disease assigned before randomization to percutaneous coronary intervention or coronary artery bypass grafting strata reported similar 5-year all-cause mortality rates with insulin sensitization versus insulin provision therapy and with a strategy of prompt in...

BACKGROUND Intensified multifactorial intervention - with tight glucose regulation and the use of renin-angiotensin system blockers, aspirin, and lipid-lowering agents - has been shown to reduce the risk of nonfatal cardiovascular disease among patients with type 2 diabetes mellitus and microalbuminuria. We evaluated whether this approach would have an effect on the rates of death from any caus...

Background: Clinical treatment goals of type 1 diabetes mellitus (T1DM) have changed since the Diabetes Control and Complications Trial (DCCT) demonstrated reduced long-term complications with intensive diabetes therapy. There have been few longitudinal studies to describe the clinical course of T1DM in the age of intensive therapy. Our objective was to describe the currentday clinical course o...

Background: Clinical treatment goals of type 1 diabetes mellitus (T1DM) have changed since the Diabetes Control and Complications Trial (DCCT) demonstrated reduced long-term complications with intensive diabetes therapy. There have been few longitudinal studies to describe the clinical course of T1DM in the age of intensive therapy. Our objective was to describe the currentday clinical course o...

AIMS The impact of intensive lipid lowering therapy with statins in acute coronary syndrome (ACS) patients with diabetes mellitus (DM) is not well characterized. METHODS AND RESULTS We explored this question in data from the Pravastatin or Atorvastatin Evaluation and Infection Therapy (PROVE IT) TIMI 22 trial, which tested standard (pravastatin 40 mg) vs. intensive (atorvastatin 80 mg) statin...

The Diabetes Control and Complications Trial (DCCT) convincingly demonstrated that intensive insulin therapy reduces the microvascular complications associated with diabetes, including retinopathy, neuropathy, and nephropathy. However, intensive insulin therapy that lowers blood glucose towards normal levels also significantly increases the risk for hypoglycemia. Moderate hypoglycemia can acute...

BACKGROUND Antibiotic surveillance is mandatory to optimise antibiotic therapy. Our objectives were to evaluate antibiotic use in our pediatric intensive care unit (PICU) and to implement a simple achievable intervention aimed at improving antibiotic therapy. METHOD Prospective, 3 months surveillance of antibiotic use on PICU (phase I) and evaluation according to the CDC 12-step campaign with...

Submit Manuscript | http://medcraveonline.com dynamic and systematic procedure intended to achieve the goals of optimum critical care management. In this regard, nurse anesthetists and intensive care nursing personnel are indispensable. Their dedicated efforts guided by the intensivists are undoubtedly responsible for improved patient outcomes. This article is primarily intended for them and ot...