Les résultats de l'étude NICE-Sugar seront très intéressants à avoir lorsque publiés: http://www.ncbi.nlm.nih.gov/pubmed/19281445?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
Patrick Archambault 2009/3/25 M. Chenier <[email protected]> > C'est pas la seule dans le domaine du contrôle intensif de la glycémie: > > http://www.ncbi.nlm.nih.gov/pubmed/18539917?dopt=Abstract > http://www.ncbi.nlm.nih.gov/pubmed/18728267?dopt=Abstract > > *M. Chénier* > > *[email protected]* > > > > > > Alain Vadeboncoeur wrote: > > Fascinant quand même de nombre d'études qui se publient sur L'ABSENCE de > gains dans divers contextes d'un contrôle serré de la glycémie! > > Alain > > ------------------------------ > *From:* [email protected] [mailto:[email protected] <[email protected]>] > *On Behalf Of *Équipe éditoriale de amc.ca > *Sent:* 25 mars 2009 04:00 > *To:* [email protected] > *Subject:* InfoPOEM: Intensive glucose control ineffective in ICU patients > > Pour assurer la livraison de ce courriel dans votre boîte de réception, > veuillez ajouter [email protected] <[email protected]> à votre carnet de contacts. > > > Intensive glucose control ineffective in ICU patients > > *Clinical question * > Does tight control of blood glucose improve survival of patients in a > medical surgical intensive care unit? > > *Bottom line * > Tight control of blood glucose levels -- 80 mg/dL to 110 mg/dL (4.4-6.1 > mmol/L) -- did not decrease mortality or other measured outcomes in patients > admitted to an intensive care unit (ICU) with hyperglycemia. Hypoglycemia > was much more common and was associated with an increased mortality. A > meta-analysis has found similar results. (LOE = > 1b)<http://mailer.cma.ca/t/4155251/234493/102001/0/> > > *Reference * > Arabi YM, Dabbagh OC, Tamim HM, et al. Intensive versus conventional > insulin therapy: A randomized controlled trial in medical and surgical > critically ill patients. Crit Care Med > 2008;36(12):3190-3197.<http://mailer.cma.ca/t/4155251/234493/4597965/0/> > > *Study design* > Randomized controlled trial (nonblinded) > > *Funding* > Foundation > > *Allocation* > Concealed > > *Setting* > Inpatient (ICU only) > Obtenez des crédits > Mainpro <http://mailer.cma.ca/t/4155251/234493/4598439/0/> Discutez de > cet > InfoPOEM <http://mailer.cma.ca/t/4155251/234493/4597967/0/> > Archives<http://mailer.cma.ca/t/4155251/234493/145011/0/> > Bilan des crédits <http://mailer.cma.ca/t/4155251/234493/177011/0/> Plus > de FMC / DPC <http://mailer.cma.ca/t/4155251/234493/3021/0/> > > <http://mailer.cma.ca/t/4155251/234493/196001/0/> > Publicité > Bibliothécaire de l'AMC<http://mailer.cma.ca/t/4155251/234493/147004/0/> > Envoyez-nous vos commentaires <[email protected]> > > *Synopsis * > The Saudi Arabian investigators conducting this study enrolled 523 adults > in a medical surgical ICU. The unit was closed and covered at all times by > an intensivist. The patients (75% men) did not have type 1 diabetes, though > 40% had a history of type 2 diabetes. The average blood glucose level was > 194 mg/dL (10.8 mmol/L) in the intensive insulin group and 210 mg/dL (11.7 > mmol/L) in the conventional insulin group. Most of the patients were > nonoperative and were critically ill; 85% were mechanically ventilated and > 65% were receiving vasopressors, with a mortality rate was approximately > 15%. All patients received an infusion of regular insulin and were randomly > assigned, using concealed allocation, to have their blood glucose maintained > at 80 mg/dL to 110 mg/dL (4.4 - 6.1 mmol/L) in the intensive insulin group > and 180 mg/dL to 200 mg/dL (10.0-11.1 mmol/L) in the conventional treatment > group. Analysis was by intention to treat. The main outcome, in-ICU > mortality, was not different between the 2 groups. At least one episode of > hypoglycemia occurred in 28.6% of patients in the tight control group and > 3.1% of patients in the conventional treatment group. In-ICU mortality was > higher among those who had hypoglycemia (23.8% vs 13.7%; P = .02). There was > no difference in in-hospital mortality, ICU or hospital length of stay, > ventilation duration, infections, or the need for transfusion. These results > are similar to those found in a previous meta-analysis (JAMA > 2008;300(8):933-944). > > Discutez de cet InfoPOEM<http://mailer.cma.ca/t/4155251/234493/4597967/0/> > > *Archives* > > InfoPOEMs (contenu anglais)<http://mailer.cma.ca/t/4155251/234493/145011/0/>| > CLIPs > (contenu anglais) <http://mailer.cma.ca/t/4155251/234493/322001/0/> | Critique > et pratique <http://mailer.cma.ca/t/4155251/234493/177003/0/> > > *Ressources cliniques* > > Accueil <http://mailer.cma.ca/t/4155251/234493/94016/0/> | Manuels > *<http://mailer.cma.ca/t/4155251/234493/177004/0/>| Revues > * <http://mailer.cma.ca/t/4155251/234493/177005/0/> | Information > médicaments * <http://mailer.cma.ca/t/4155251/234493/145012/0/> | Tests de > laboratoire * <http://mailer.cma.ca/t/4155251/234493/128015/0/> | > InfoPOEMs <http://mailer.cma.ca/t/4155251/234493/145011/0/> | Guide de > pratique clinique <http://mailer.cma.ca/t/4155251/234493/324016/0/> | > > Documents d'information pour les patients > *<http://mailer.cma.ca/t/4155251/234493/177007/0/>| Bibliothécaire > de l'AMC * <http://mailer.cma.ca/t/4155251/234493/147004/0/> > > *Raccourcis* > > MD Consult * <http://mailer.cma.ca/t/4155251/234493/145015/0/> | STAT!Ref > * <http://mailer.cma.ca/t/4155251/234493/148015/0/> | [email protected] > *<http://mailer.cma.ca/t/4155251/234493/177008/0/>| OVID > Medline * <http://mailer.cma.ca/t/4155251/234493/145016/0/> | Revues EBSCO > * <http://mailer.cma.ca/t/4155251/234493/145014/0/> | > JAMC<http://mailer.cma.ca/t/4155251/234493/177009/0/>| Essential > Evidence Plus <http://mailer.cma.ca/t/4155251/234493/138018/0/>| MedCalc > 3000 * <http://mailer.cma.ca/t/4155251/234493/177010/0/> > > *FMC / DPC* > > Voir les cours en ligne <http://mailer.cma.ca/t/4155251/234493/3021/0/> | > Bilan > des crédits <http://mailer.cma.ca/t/4155251/234493/177011/0/> > > *Gestion de la pratique* > > Accueil <http://mailer.cma.ca/t/4155251/234493/77020/0/> | Créez un site > Web de pratique <http://mailer.cma.ca/t/4155251/234493/140/0/> | Clinique > informatisée <http://mailer.cma.ca/t/4155251/234493/234014/0/> | > Bureau<http://mailer.cma.ca/t/4155251/234493/234015/0/>| Dotation > en personnel <http://mailer.cma.ca/t/4155251/234493/234016/0/> | > Finances<http://mailer.cma.ca/t/4155251/234493/234017/0/>| Juridique > et vie privée <http://mailer.cma.ca/t/4155251/234493/234018/0/> > > * Service aux membres AMC > POEMs veut dire "Patient-Oriented Evidence that Matters". > > Désirez-vous changer le format de vos courriels d'InfoPOEMs quotidiens ou > votre adresse courriel de la liste d'InfoPOEMs quotidiens? > Gérez vos options d'InfoPOEMs > quotidiens<http://mailer.cma.ca/t/4155251/234493/3026/0/>à partir du site Web > amc.ca. > Cliquez ici pour vous > désabonner<http://mailer.cma.ca/u?id=234493.2ee32010d4b1d8089bbf2b767ebd5713&o=4155251&u=http://www.cma.ca/index.cfm/ci_id/324/la_id/2.htm&w=F&a=T&c=F&l=poem>. > > > Copyright © 1995-2009 InfoPOEM, Inc. > www.infopoems.com<http://mailer.cma.ca/t/4155251/234493/3966545/0/>. > Tous droits réservés. > Copyright © 2009 Association Médicale Canadienne, Tous droits réservés. > >
