Evaluation of Optimal Goal of Glucose Control in Critically Ill Patients

Objective To investigate the influence of two different levels of glucose control on ICU outcome,therefore to assess the optimal glucose control goal in ICU patients.Methods A total of 338 patients,who admitted to our ICU from May 2006 to December 2007 and anticipated to stay no less than 2 days,were randomly divided into two groups according to the target glucose-control levels:Group A:the mean blood glucose(MBG) was maintained at the level of 4.4-6.1 mmol/L(80-110 mg/dl,n=168);and Group B:MBG was maintained at the level of 7.2-8.3 mmol/L(130-150 mg/dl,n=170).Blood glucose levels were controlled by continuous insulin infusion.The outcome was evaluated by mechanical ventilation time within 28 days of admission,length of ICU and hospital stay,incidence of infection,hospital mortality,amount of red blood cell infusion,and ICU costs.Results No significant difference was found in the outcome between the two groups(P0.05),while the ratio of hypoglycemia(blood glucose3.3 mmol/L)in group A was significantly higher than that in group B(1.87% vs.0.86%,P0.01).Conclusions To maintain the blood glucose of critically ill patients at a normal level does not necessarily improve the outcome;on the contrary,it may increase the risk of hypoglycemia.Maintaining the blood glucose level at ≤8.3 mmol/L may be a safer and more reasonable goal.