Pierre Kalfon Bruno Giraudeau Carole Ichai Alexandre Guerrini Nicolas Brechot Raphae ¨l Cinotti Pierre-Franc ¸ois Dequin Be ´atrice Riu-Poulenc Philippe Montravers Djilalli Annane Herve ´ Dupont Michel Sorine Bruno Riou On behalf of the CGAO–REA Study Group Tight computerized versus conventional glucose control in the ICU: a randomized controlled trial Received: 29 October 2013 Accepted: 4 December 2013 Published online: 14 January 2014 Ó Springer-Verlag Berlin Heidelberg and ESICM 2013 We dedicate this article to the memory of our distinguished colleague Xavier Leverve, MD, PhD, who sadly did not live to see the result of the trial. Take-home message: Despite the increase in the incidence of severe hypoglycemia in our experimental group, based on the absence of difference in mortality between patients on tight computerized glucose control and those on less stringent glucose control without CDSS, this study could pave the way for future randomized controlled trials assessing new generation CDSSs allowing the safe implementation of blood glucose control in the ICU that take into account the complexity of glucose control throughout the ICU stay and the variability of individualized insulin needs. Trial registration: Clinicaltrials.gov Identifier NCT01002482. Electronic supplementary material The online version of this article (doi:10.1007/s00134-013-3189-0) contains supplementary material, which is available to authorized users. P. Kalfon ( ) ) Service de Re ´animation polyvalente, Ho ˆpital Louis Pasteur, Ho ˆpitaux de Chartres, Chartres Cedex 28018, Le Coudray, France e-mail: pkalfon@ch-chartres.fr; pierrekalfon@sfr.fr Tel.: ?33-2-37303073 Fax: ?33-2-37303239 P. Kalfon Á B. Riou UMR INSERM 956, Universite ´ Pierre et Marie Curie, Paris, France B. Giraudeau INSERM CIC (Centre d’investigation clinique) 202, Centre Hospitalier Universitaire (CHU) de Tours, Tours, France C. Ichai Service de Re ´animation me ´dico- chirurgicale, Ho ˆpital Saint-Roch, CHU de Nice, Nice, France A. Guerrini LK2, Saint-Avertin, France A. Guerrini Á M. Sorine Institut National de Recherche en Informatique et en Automatique (INRIA), Rocquencourt, France N. Brechot Service de Re ´animation me ´dicale, Institut de Cardiologie, CHU Pitie ´-Salpe ˆtrie `re, Assistance Publique-Ho ˆpitaux de Paris (AP-HP), Paris, France R. Cinotti Service de Re ´animation chirurgicale cardio- thoracique et vasculaire, Ho ˆpital Laennec, CHU de Nantes, Nantes, France P.-F. Dequin Service de Re ´animation me ´dicale, Ho ˆpital Bretonneau, CHRU de Tours, Tours, France B. Riu-Poulenc Service de Re ´animation polyvalente, Ho ˆpital Purpan, CHU de Toulouse, Toulouse, France P. Montravers De ´partement d’Anesthe ´sie et Re ´animation chirurgicale, CHU Bichat-Claude Bernard, AP-HP, Paris, France D. Annane Service de Re ´animation, CHU Raymond Poincare ´, AP-HP, Garches, France H. Dupont Service d’Anesthe ´sie Re ´animation, Ho ˆpital Nord, CHRU Amiens, Amiens, France B. Riou Service d’accueil des Urgences, CHU Pitie ´-Salpe ˆtrie `re, AP-HP, Paris, France Abstract Purpose: The blood glucose target range and optimal method to reach this range remain a matter of debate in the intensive care unit (ICU). A computer decision support system (CDSS) might improve the outcome of ICU patients through facilitation of a tighter blood glucose control. Methods: We con- ducted a multi-center randomized trial in 34 French ICU. Adult patients expected to require treatment in the ICU for at least 3 days were ran- domly assigned without blinding to undergo tight computerized glucose control with the CDSS (TGC) or conventional glucose control (CGC), with blood glucose targets of 4.4–6.1 and \ 10.0 mmol/L, respectively. The primary outcome was all-cause death Intensive Care Med (2014) 40:171–181 DOI 10.1007/s00134-013-3189-0 SEVEN-DAY PROFILE PUBLICATION