Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Tight glycaemic control in the intensive care unit: pitfalls in the testing of the concept. | Available online http content 12 5 187 Commentary Tight glycaemic control in the intensive care unit pitfalls in the testing of the concept Dieter Mesotten Department of Intensive Care Medicine Catholic University of Leuven University Hospital Leuven Herestraat 49 B-3000 Leuven Belgium Corresponding author Dieter Mesotten Published 24 October 2008 This article is online at http content 12 5 187 2008 BioMed Central Ltd Critical Care 2008 12 187 doi cc7086 See related research by De La Rosa et al. http content 12 5 R120 Abstract Tight glycaemic control emerged on the scene of critical care in 2001. Surprisingly not many confirmation trials have been published so far. The randomised controlled trial by De La Rosa and colleagues is a timely and valuable attempt to repeat the landmark Leuven studies. The failure to replicate the beneficial effects of tight glycaemic control may boil down to some less obvious defaults in the set-up of the trial despite a seemingly adequate study design. The incorporation of ample power calculations and strict adherence to glucose targets are essential to fairly compare studies on tight blood glucose control. Only if these basic conditions of study design are fulfilled can the effectiveness of the therapy be assessed. The study of De La Rosa and colleagues 1 is the first published randomised controlled trial set up to test whether tight glycaemic control in a mixed medical-surgical intensive care unit ICU population is beneficial. The proof-of-concept work by Van den Berghe and colleagues 2 in Leuven showed in two separate single-centre studies that lowering blood glucose levels to 80 to 110mg dL to mM compared with a strategy in which insulinisation is started only when blood glucose levels exceeded 180 mg dL 10 mM improved the outcome in a surgical 2 as well as in a medical 3 ICU patient population. The trial of De La Rosa and colleagues did not confirm
