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Intensive glucose control in critically ill adults: a protocol for a systematic review and individual patient data meta-analysis.
Adigbli, Derick; Yang, Li; Hammond, Naomi; Annane, Djillali; Arabi, Yaseen; Bilotta, Federico; Bohé, Julien; Brunkhorst, Frank Martin; Cavalcanti, Alexandre Biasi; Cook, Deborah; Engel, Christoph; Green-LaRoche, Deborah; He, Wei; Henderson, William; Hoedemaekers, Cornelia; Iapichino, Gaetano; Kalfon, Pierre; Rosa, Gisela de La; MacKenzie, Iain; Mélot, Christian; Mitchell, Imogen; Oksanen, Tuomas; Polli, Federico; Preiser, Jean-Charles; Soriano, Francisco Garcia; Wang, Ling-Cong; Yuan, Jiaxiang; Delaney, Anthony; Tanna, Gian Luca Di; Finfer, Simon.
Afiliación
  • Adigbli D; Critical Care Division, The George Institute for Global Health - New South Wales, Australia.
  • Yang L; Critical Care Division, The George Institute for Global Health - New South Wales, Australia.
  • Hammond N; Critical Care Division, The George Institute for Global Health - New South Wales, Australia.
  • Annane D; Critical Care Medicine, University of Paris - Paris, France.
  • Arabi Y; Intensive Care Department, Medical Director of Respiratory Services, King Saud Bin Abdulaziz University for Health Sciences - Riyadh, Saudi Arabia.
  • Bilotta F; Department of Anesthesiology, Critical Care and Pain Medicine, Policlinico Umberto I, Sapienza University of Rome - Rome, Italy.
  • Bohé J; Service d'Anesthésie-Réanimation-Médecine Intensive, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France.
  • Brunkhorst FM; Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital - Jena, Germany.
  • Cavalcanti AB; Research Institute, HCor-Hospital do Coração - São Paulo (SP), Brazil.
  • Cook D; Critical Care Medicine, St Joseph's Healthcare Hamilton - Ontario, Canada.
  • Engel C; Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany.
  • Green-LaRoche D; Clinical Research, Tufts University School of Medicine -Boston, MA, United States.
  • He W; Department of Critical Care Medicine, Beijing Tong Ren Hospital, Capital Medical University - Beijing, China.
  • Henderson W; VA Emergency Operations Centre, UBC Hospital, University of British Columbia - Columbia, Canada.
  • Hoedemaekers C; Department of Critical Care, Radboud University Nijmegen Medical Centre -Nijmegen, The Netherlands.
  • Iapichino G; Anestesiologia e Rianimazione, Universitá degli Studi di Milano - Milano, Italy.
  • Kalfon P; Hôpital Privé de la Casamance - Aubagne, France.
  • Rosa G; Intensive Care Department, Hospital Pablo Tobon Uribe - Medellin, Colombia.
  • MacKenzie I; InterSystems Corporation - Cambridge, Mass. , United States.
  • Mélot C; Université Libre de Bruxelles - Bruxelles, Belgium.
  • Mitchell I; Australian National University - Canberra, Australia.
  • Oksanen T; Department of Anesthesiology and Intensive Care, Helsinki University Hospital and University of Helsinki - Helsinki, Finland.
  • Polli F; IRCCS Foundation, Cà Granda Hospital - Milan, Italy.
  • Preiser JC; Université Libre de Bruxelles - Bruxelles, Belgium.
  • Soriano FG; Department of Critical Care Medicine, Hospital das Clinicas, Universidade de São Paulo - São Paulo, Brazil.
  • Wang LC; Intensive Care Unit, The First Affiliated Hospital of Zhejiang Traditional Chinese Medical University - Zhejiang, China.
  • Yuan J; Department of Laparoscopic Surgery, The First Affiliated Hospital of Zhengzhou University - Zhengzhou, China.
  • Delaney A; Critical Care Division, The George Institute for Global Health - New South Wales, Australia.
  • Tanna GLD; Critical Care Division, The George Institute for Global Health - New South Wales, Australia.
  • Finfer S; Critical Care Division, The George Institute for Global Health - New South Wales, Australia.
Crit Care Sci ; 35(4): 345-354, 2023.
Article en En, Pt | MEDLINE | ID: mdl-38265316
ABSTRACT

OBJECTIVE:

The optimal target for blood glucose concentration in critically ill patients is unclear. We will perform a systematic review and meta-analysis with aggregated and individual patient data from randomized controlled trials, comparing intensive glucose control with liberal glucose control in critically ill adults. DATA SOURCES MEDLINE®, Embase, the Cochrane Central Register of Clinical Trials, and clinical trials registries (World Health Organization, clinical trials.gov). The authors of eligible trials will be invited to provide individual patient data. Published trial-level data from eligible trials that are not at high risk of bias will be included in an aggregated data meta-analysis if individual patient data are not available.

METHODS:

Inclusion criteria randomized controlled trials that recruited adult patients, targeting a blood glucose of ≤ 120mg/dL (≤ 6.6mmol/L) compared to a higher blood glucose concentration target using intravenous insulin in both groups. Excluded studies those with an upper limit blood glucose target in the intervention group of > 120mg/dL (> 6.6mmol/L), or where intensive glucose control was only performed in the intraoperative period, and those where loss to follow-up exceeded 10% by hospital discharge. PRIMARY ENDPOINT In-hospital mortality during index hospital admission. Secondary endpoints mortality and survival at other timepoints, duration of invasive mechanical ventilation, vasoactive agents, and renal replacement therapy. A random effect Bayesian meta-analysis and hierarchical Bayesian models for individual patient data will be used.

DISCUSSION:

This systematic review with aggregate and individual patient data will address the clinical question, 'what is the best blood glucose target for critically ill patients overall?'Protocol version 0.4 - 06/26/2023PROSPERO registrationCRD42021278869.
Asunto(s)

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Glucemia / Enfermedad Crítica Tipo de estudio: Clinical_trials / Guideline / Prognostic_studies / Systematic_reviews Idioma: En / Pt Revista: Crit Care Sci Año: 2023 Tipo del documento: Article

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Glucemia / Enfermedad Crítica Tipo de estudio: Clinical_trials / Guideline / Prognostic_studies / Systematic_reviews Idioma: En / Pt Revista: Crit Care Sci Año: 2023 Tipo del documento: Article