Abstract
The article by Eslami and colleagues provides an overview of the indicators used to measure the quality of blood glucose control in patients admitted to the intensive care unit. Each indicator can be related to one or more of the following categories: blood glucose zones, blood glucose levels, time intervals, and features of the insulin titration algorithm. Some important issues (for instance those concerning the clarity of definitions used for glycaemic thresholds) are raised. This systematic review calls for a practical guide to advise the clinician how different blood glucose signals should (ideally) be evaluated and which steps should to be undertaken.
Highlights
In recent years, the definition of TGC had appeared to be well established, based on the findings of two randomized controlled clinical trials that clearly demonstrated the relation between strictly regulated blood glucose (BG) (80 to 110 mg/dl) and reduction in mortality/morbidity [2,3]
In the previous issue of Critical Care, Eslami and coworkers [1] review the various outcome measures used to evaluate the quality of blood glucose (BG) control in critically ill patients; the review considers studies published prior to 2008
Control of BG to achieve a clinically and ethically approved target remains a crucial element in the treatment of intensive care unit (ICU) patients and necessitates the design and assessment of measures that reflect this level of control
Summary
The definition of TGC had appeared to be well established, based on the findings of two randomized controlled clinical trials that clearly demonstrated the relation between strictly regulated BG (80 to 110 mg/dl) and reduction in mortality/morbidity [2,3]. In the previous issue of Critical Care, Eslami and coworkers [1] review the various outcome measures used to evaluate the quality of blood glucose (BG) control (level of ‘tight glycaemic control’ [TGC]) in critically ill patients; the review considers studies published prior to 2008. Control of BG to achieve a clinically and ethically approved target remains a crucial element in the treatment of intensive care unit (ICU) patients and necessitates the design and assessment of measures that reflect this level of control.
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