Insulin drips in the ICU seem to swing the tight vs liberal control pendulum every few years. In the last 10 years of my medical life I have gone from putting no one on an insulin drip to putting everyone on an insulin drip in the ICU with the goal of perfect control. New research suggests that it is time to back off. A large international randomized trial sets the bar at a blood sugar of <180 mg/dl, not a normal blood sugar. I had the journal linked, but the link has since died. You'll just have to trust me, or continue your search elsewhere.
What will I do all night if I'm not doing hourly glucoses on all of my patients?
ReplyDeleteI thought the results mainly only applied to cardiovascular deaths and so there is some caution at this point not to change things drastically just yet until more studies are done.
ReplyDeleteThats why they need to get that ICU-friendly continuous glucose monitor developed and in use asap so severe hypo(and hyper)glycemia is significantly reduced.
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