Prof. James Krinsley
******@***stamhealth.org
Stamford Hospital
ICU Volume 14 - Issue 1 - Spring 2014 - Matrix
Glycaemic Control in the Critically Ill: What Have We Learned Since NICE-
SUGAR?
Author
James S. Krinsley, MD, FCCM
Director of Critical Care, Stamford Hospital Stamford, Connecticut
Clinical Professor of Medicine, Columbia University College of Physicians and Surgeons
New York, USA
jkrinsley@stamhealth.org
Introduction
Glycaemic control of the critically ill has been a topic of considerable interest in the critical care
community since the publication of a single-centre randomised controlled trial (RCT) of intensive
insulin therapy (IIT) targeting euglycaemia, blood glucose (BG) 80-110 mg/dL, in a population of
mechanically ventilated surgical intensive care unit (ICU) patients, 63% of whom had undergone
cardiovascular surgery (Van den Berghe et al. 2003). However, the dramatic reductions in mortality
and morbidity demonstrated in this investigation were not reproduced in subsequent trials (Van den
Berghe et al. 2006; Brunkhorst et al. 2008; Preiser et al. 2009; Arabi et al. 2008), two of which
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