The Safety And Efficacy Of Intensive Insulin Therapy In Critically Ill Patients:a Meta-analysis

ObjectiveTo assess the safety and efficacy of intensive insulin therapy(IIT), compared with conventional insulin therapy(CIT), on mortality, infection rate, incidence MODS et al.MethodsComputer retrieval was conducted to search for randomly controlled trials(1993-2011)to compare the mortality, infection rate, incidence MODS and hypoglycemia with IIT and CIT. The quality of included studies was critically evaluated and the data were analyzed with RevMan5.0software which provided by the Coehrane Collaboration’s.ResultsA total of50studies were included in the Meta-analyses. The results showed that there were significant differences between IIT and CIT in the mortality, infection rate, incidence MODS, et al, with significant lowering in IIT groups. However, the incidence of hypoglycemia was slightly lower in CIT groups.ConclusionⅡT can decreased the mortality rate, infection rate, and complications in critically ill patients in the ICU obviously as compared with the patients of CIT. The safety and effectiveness of the ⅡT treatment groups are better than the CIT groups, and the ⅡT can also improve the quality of life. However, ⅡT is not as good as CIT in the control of hypoglycemia. Strict blood sugar monitor and blood glucose control or relaxing range to4.4-8.3mol/L can effectively reduce the risk of hypoglycemia.