Intensive Care Med (2017) 43:1427–1429 DOI 10.1007/s00134-017-4801-5 LE T TER Glycemic control, mortality, secondary infection, and hypoglycemia in critically ill pediatric patients: a systematic review and network meta-analysis of randomized controlled trials 1* 1 2 3 1 Tomohide Yamada , Nobuhiro Shojima , Kazuo Hara , Hisashi Noma , Toshimasa Yamauchi and Takashi Kadowaki © 2017 Springer-Verlag Berlin Heidelberg and ESICM We recently reported a network meta-analysis on the 1). This research was performed according to a predeter - risk of mortality or hypoglycemia associated with differ - mined protocol and followed the Cochrane Collaboration ent glycemic control targets in critically ill adults [1, 2]. recommendations (supplemental 2). Our analysis of 36 randomized trials (17,996 patients) Five well-designed randomized trials were identi- showed no reduction of mortality by tight glycemic con- fied (4001 patients; 205 mortality events, 411 second - trol (blood glucose: 4.4–<6.1 mmol/l), while hypoglyce- ary infection events, 530 hypoglycemia events, and 224 mia was fivefold more frequent versus mild control (7.8– severe hypoglycemia events) (supplemental 3). All 5 stud- <10.0 mmol/l) or very mild control (10.0–<12.2 mmol/l) ies employed tight control, 3 employed very mild control, . and 2 employed mild control. However, the optimal glycemic control target for criti- Compared with
Intensive Care Medicine – Springer Journals
Published: Apr 19, 2017
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