Intensive versus conventional glucose control in critically ill patients with traumatic brain injury: long-term follow-up of a subgroup of patients from the NICE-SUGAR study

The NICE-SUGAR Study Investigators for the ANZ Intensive Care Society Clinical Trials Group and the Canadian Critical Care Trials Group; Denise Foster; Vinay Dhingra; Rinaldo Bellomo; Deborah Cook; Peter Dodek; Paul Hebert; William Henderson; John Myburgh; Deborah Blair; Robyn Norton; Daren Heyland; Ellen McDonald; Juan Ronco; Richard Peto; Peter Sandercock; Charles Sprung; J. Duncan Young; Yang Li; Qiang Li; Severine Bompoint; Laurent Billot; Leonie Crampton; Fotios Darcy; Kathy Jayne; Viraji Kumarasinghe; Lorraine Little; Suzanne McEvoy; Stephen MacMahon; Sameer Pandey; Suzanne Ryan; Ravi Shukla; Bala Vijayan; Bruce Robinson; Susan Atherton; Jeanette Bell; Louise Hadfield; Craig Hourigan; Colin McArthur; Lynette Newby; Catherine Simmonds; Heidi Buhr; Michelle Eccleston; Shay McGuinness; Rachael Parke; Rinaldo Bellomo; Samantha Bates; Donna Goldsmith; Inga Mercer; Kim O’Sullivan; Robert Gazzard; Dianne Hill; Christine Tauschke; Dhawal Ghelani; Kiran Nand; Graham Reece; Treena Sara; Suzanne Elliott; David Ernest; Angela Hamilton; Rebecca Ashley; Andrew Bailey; Elise Crowfoot; Jelena Gissane; Imogen Mitchell; Jamie Ranse; Joy Whiting; Kristina Douglas; David Milliss; Jeff Tan; Helen Wong; David Blythe; Annemarie Palermo; Miranda Hardie; Peter Harrigan; Brett McFadyen; Sharon Micallef; Michael Parr; Anna Boase; Judi Tai; Anthony Williams; Louise Cole; Ian Seppelt; Leonie Weisbrodt; Sarah Whereat; Annette Flanagan; Janet Liang; Frances Bass; Michelle Campbell; Naomi Hammond; Lisa Nicholson; Yahya Shehabi; Jonathan Foote; Sandra Peake; Patricia Williams; Renae Deans; Cheryl Fourie; Melissa Lassig-Smith; Jeffrey Lipman; Janine Stuart; Anthony Bell; Tanya Field; Richard McAllister; Kathryn Marsden; Andrew Turner; Susan Ankers; Simon Bird; Simon Finfer; Richard Lee; Anne O’Connor; Julie Potter; Naresh Ramakrishnan; Ray Raper; Vanessa Dhiacou; Kathryn Girling; Alina Jovanovska; Nicole Groves; Jenny Holmes; John Santamaria; Roger Smith; Stuart Baker; Brigit Roberts; Lynne Andrews; Richard Dinsdale; Rosemary Fenton; Diane Mackle; Sarah Mortimer; Craig French; Heike Raunow; Michelle Gales; Francisco Hill; Sundaram Rachakonda; Darren Rogan; Christine Allsop; Alisa Higgins; Dinesh Varma; Kevin Champagne; Christopher Doig; Linda Knox; Pauline Taylor; Crystal Wilson; John Drover; Sharlene Hammond; Elizabeth Mann; Monica Myers; Amber Robinson; Johanne Harvey; Yoanna Skrobik; Anita Baumgartner; Laurie Meade; Nicholas Vlahakis; Cheryl Ethier; Marnie Kramer-Kile; Sangeeta Mehta; Claude Gaudert; Salmaan Kanji; Tracy McArdle; Irene Watpool; France Clark; Deborah Cook; Andrea Tkaczyk; John Marshall; Jeanna Morrissey; Orla Smith; Kerri Porretta; Victoria Wen; Betty Jean Ashley; Sheilagh Mans; Boris Bojilov; Karen Code; Robert Fowler; Nicole Marinoff; Leslie Chu; John Granton; Margaret McGrath-Chong; Marilyn Steinberg; Niall Ferguson; Stephanie Go; Andrea Matte; Jonathan Rosenberg; James Stevenson; Michael Jacka; Leeca Sonnema; Roger Autio; Angela Brevner; Dean Chittock; Dara Davies; Pia Ganz; Maureen Gardner; Susan Logie; Laurie Smith; Leslie Atkins; Fiona Auld; Marni Stewart; Gordon Wood

doi:10.1007/s00134-015-3757-6

Intensive versus conventional glucose control in critically ill patients with traumatic brain injury: long-term follow-up of a subgroup of patients from the NICE-SUGAR study

The NICE-SUGAR Study Investigators for the ANZ Intensive Care Society Clinical Trials Group and the Canadian Critical Care Trials Group, Denise Foster, Vinay Dhingra, Rinaldo Bellomo, Deborah Cook, Peter Dodek, Paul Hebert, William Henderson, John Myburgh, Deborah Blair, Robyn Norton, Daren Heyland, Ellen McDonald, Juan Ronco, Richard Peto, Peter Sandercock, Charles Sprung, J. Duncan Young, Yang Li, Qiang LiSeverine Bompoint, Laurent Billot, Leonie Crampton, Fotios Darcy, Kathy Jayne, Viraji Kumarasinghe, Lorraine Little, Suzanne McEvoy, Stephen MacMahon, Sameer Pandey, Suzanne Ryan, Ravi Shukla, Bala Vijayan, Bruce Robinson, Susan Atherton, Jeanette Bell, Louise Hadfield, Craig Hourigan, Colin McArthur, Lynette Newby, Catherine Simmonds, Heidi Buhr, Michelle Eccleston, Shay McGuinness, Rachael Parke, Rinaldo Bellomo, Samantha Bates, Donna Goldsmith, Inga Mercer, Kim O’Sullivan, Robert Gazzard, Dianne Hill, Christine Tauschke, Dhawal Ghelani, Kiran Nand, Graham Reece, Treena Sara, Suzanne Elliott, David Ernest, Angela Hamilton, Rebecca Ashley, Andrew Bailey, Elise Crowfoot, Jelena Gissane, Imogen Mitchell, Jamie Ranse, Joy Whiting, Kristina Douglas, David Milliss, Jeff Tan, Helen Wong, David Blythe, Annemarie Palermo, Miranda Hardie, Peter Harrigan, Brett McFadyen, Sharon Micallef, Michael Parr, Anna Boase, Judi Tai, Anthony Williams, Louise Cole, Ian Seppelt, Leonie Weisbrodt, Sarah Whereat, Annette Flanagan, Janet Liang, Frances Bass, Michelle Campbell, Naomi Hammond, Lisa Nicholson, Yahya Shehabi, Jonathan Foote, Sandra Peake, Patricia Williams, Renae Deans, Cheryl Fourie, Melissa Lassig-Smith, Jeffrey Lipman, Janine Stuart, Anthony Bell, Tanya Field, Richard McAllister, Kathryn Marsden, Andrew Turner, Susan Ankers, Simon Bird, Simon Finfer, Richard Lee, Anne O’Connor, Julie Potter, Naresh Ramakrishnan, Ray Raper, Vanessa Dhiacou, Kathryn Girling, Alina Jovanovska, Nicole Groves, Jenny Holmes, John Santamaria, Roger Smith, Stuart Baker, Brigit Roberts, Lynne Andrews, Richard Dinsdale, Rosemary Fenton, Diane Mackle, Sarah Mortimer, Craig French, Heike Raunow, Michelle Gales, Francisco Hill, Sundaram Rachakonda, Darren Rogan, Christine Allsop, Alisa Higgins, Dinesh Varma, Kevin Champagne, Christopher Doig, Linda Knox, Pauline Taylor, Crystal Wilson, John Drover, Sharlene Hammond, Elizabeth Mann, Monica Myers, Amber Robinson, Johanne Harvey, Yoanna Skrobik, Anita Baumgartner, Laurie Meade, Nicholas Vlahakis, Cheryl Ethier, Marnie Kramer-Kile, Sangeeta Mehta, Claude Gaudert, Salmaan Kanji, Tracy McArdle, Irene Watpool, France Clark, Deborah Cook, Andrea Tkaczyk, John Marshall, Jeanna Morrissey, Orla Smith, Kerri Porretta, Victoria Wen, Betty Jean Ashley, Sheilagh Mans, Boris Bojilov, Karen Code, Robert Fowler, Nicole Marinoff, Leslie Chu, John Granton, Margaret McGrath-Chong, Marilyn Steinberg, Niall Ferguson, Stephanie Go, Andrea Matte, Jonathan Rosenberg, James Stevenson, Michael Jacka, Leeca Sonnema, Roger Autio, Angela Brevner, Dean Chittock, Dara Davies, Pia Ganz, Maureen Gardner, Susan Logie, Laurie Smith, Leslie Atkins, Fiona Auld, Marni Stewart, Gordon Wood

Research output: Contribution to journal › Article › peer-review

101 Citations (Scopus)

Abstract

Purpose: To compare the effect of intensive versus conventional blood glucose control in patients with traumatic brain injury. Methods: In a large international randomized trial patients were randomly assigned to a target blood glucose (BG) range of either 4.5–6.0 mmol/L (intensive control) or <10 mmol/L (conventional control). Patients with traumatic brain injury (TBI) were identified at randomization and data were collected to examine the extended Glasgow outcome score (includes mortality) at 24 months. Results: Of the 6104 randomized patients, 391 satisfied diagnostic criteria for TBI; 203 (51.9 %) were assigned to intensive and 188 (48.1 %) to conventional control; the primary outcome was available for 166 (81.8 %) and 149 (79.3 %) patients, respectively. The two groups had similar baseline characteristics. At 2 years 98 (58.7 %) patients in the intensive group and 79 (53.0 %) in the conventional group had a favorable neurological outcome (odds ratio [OR] 1.26, 95 % CI 0.81–1.97; P = 0.3); 35 patients (20.9 %) in the intensive group and 34 (22.8 %) in the conventional group had died (OR 0.90, 95 % CI 0.53–1.53; P = 0.7); moderate hypoglycemia (BG 2.3–3.9 mmol/L; 41–70 mg/dL) occurred in 160/202 (79.2 %) and 17/188 (9.0 %), respectively (OR 38.3, 95 % CI 21.0–70.1; P < 0.0001); severe hypoglycemia (BG ≤ 2.2 mmol/L; ≤40 mg/dL) in 10 (4.9 %) and 0 (0.0 %), respectively (OR 20.5 95 % CI 1.2–351.6, P = 0.003). Conclusion: Although patients with traumatic brain injury randomly assigned to intensive compared to conventional glucose control experienced moderate and severe hypoglycemia more frequently, we found no significant difference in clinically important outcomes.

Original language	English
Pages (from-to)	1037-1047
Number of pages	11
Journal	Intensive Care Medicine
Volume	41
Issue number	6
DOIs	https://doi.org/10.1007/s00134-015-3757-6
Publication status	Published - 25 Jun 2015
Externally published	Yes

Keywords

Blood glucose
Brain injury
Hypoglycemia
Randomized trial
Treatment outcome

Access to Document

10.1007/s00134-015-3757-6

Cite this

The NICE-SUGAR Study Investigators for the ANZ Intensive Care Society Clinical Trials Group and the Canadian Critical Care Trials Group, Foster, D., Dhingra, V., Bellomo, R., Cook, D., Dodek, P., Hebert, P., Henderson, W., Myburgh, J., Blair, D., Norton, R., Heyland, D., McDonald, E., Ronco, J., Peto, R., Sandercock, P., Sprung, C., Young, J. D., Li, Y., ... Wood, G. (2015). Intensive versus conventional glucose control in critically ill patients with traumatic brain injury: long-term follow-up of a subgroup of patients from the NICE-SUGAR study. Intensive Care Medicine, 41(6), 1037-1047. https://doi.org/10.1007/s00134-015-3757-6

The NICE-SUGAR Study Investigators for the ANZ Intensive Care Society Clinical Trials Group and the Canadian Critical Care Trials Group ; Foster, Denise ; Dhingra, Vinay et al. / Intensive versus conventional glucose control in critically ill patients with traumatic brain injury : long-term follow-up of a subgroup of patients from the NICE-SUGAR study. In: Intensive Care Medicine. 2015 ; Vol. 41, No. 6. pp. 1037-1047.

@article{8138860bee59479c9598292710a2b7c4,

title = "Intensive versus conventional glucose control in critically ill patients with traumatic brain injury: long-term follow-up of a subgroup of patients from the NICE-SUGAR study",

abstract = "Purpose: To compare the effect of intensive versus conventional blood glucose control in patients with traumatic brain injury. Methods: In a large international randomized trial patients were randomly assigned to a target blood glucose (BG) range of either 4.5–6.0 mmol/L (intensive control) or <10 mmol/L (conventional control). Patients with traumatic brain injury (TBI) were identified at randomization and data were collected to examine the extended Glasgow outcome score (includes mortality) at 24 months. Results: Of the 6104 randomized patients, 391 satisfied diagnostic criteria for TBI; 203 (51.9 %) were assigned to intensive and 188 (48.1 %) to conventional control; the primary outcome was available for 166 (81.8 %) and 149 (79.3 %) patients, respectively. The two groups had similar baseline characteristics. At 2 years 98 (58.7 %) patients in the intensive group and 79 (53.0 %) in the conventional group had a favorable neurological outcome (odds ratio [OR] 1.26, 95 % CI 0.81–1.97; P = 0.3); 35 patients (20.9 %) in the intensive group and 34 (22.8 %) in the conventional group had died (OR 0.90, 95 % CI 0.53–1.53; P = 0.7); moderate hypoglycemia (BG 2.3–3.9 mmol/L; 41–70 mg/dL) occurred in 160/202 (79.2 %) and 17/188 (9.0 %), respectively (OR 38.3, 95 % CI 21.0–70.1; P < 0.0001); severe hypoglycemia (BG ≤ 2.2 mmol/L; ≤40 mg/dL) in 10 (4.9 %) and 0 (0.0 %), respectively (OR 20.5 95 % CI 1.2–351.6, P = 0.003). Conclusion: Although patients with traumatic brain injury randomly assigned to intensive compared to conventional glucose control experienced moderate and severe hypoglycemia more frequently, we found no significant difference in clinically important outcomes.",

keywords = "Blood glucose, Brain injury, Hypoglycemia, Randomized trial, Treatment outcome",

author = "{The NICE-SUGAR Study Investigators for the ANZ Intensive Care Society Clinical Trials Group and the Canadian Critical Care Trials Group} and Denise Foster and Vinay Dhingra and Rinaldo Bellomo and Deborah Cook and Peter Dodek and Paul Hebert and William Henderson and John Myburgh and Deborah Blair and Robyn Norton and Daren Heyland and Ellen McDonald and Juan Ronco and Richard Peto and Peter Sandercock and Charles Sprung and Young, {J. Duncan} and Yang Li and Qiang Li and Severine Bompoint and Laurent Billot and Leonie Crampton and Fotios Darcy and Kathy Jayne and Viraji Kumarasinghe and Lorraine Little and Suzanne McEvoy and Stephen MacMahon and Sameer Pandey and Suzanne Ryan and Ravi Shukla and Bala Vijayan and Bruce Robinson and Susan Atherton and Jeanette Bell and Louise Hadfield and Craig Hourigan and Colin McArthur and Lynette Newby and Catherine Simmonds and Heidi Buhr and Michelle Eccleston and Shay McGuinness and Rachael Parke and Rinaldo Bellomo and Samantha Bates and Donna Goldsmith and Inga Mercer and Kim O{\textquoteright}Sullivan and Robert Gazzard and Dianne Hill and Christine Tauschke and Dhawal Ghelani and Kiran Nand and Graham Reece and Treena Sara and Suzanne Elliott and David Ernest and Angela Hamilton and Rebecca Ashley and Andrew Bailey and Elise Crowfoot and Jelena Gissane and Imogen Mitchell and Jamie Ranse and Joy Whiting and Kristina Douglas and David Milliss and Jeff Tan and Helen Wong and David Blythe and Annemarie Palermo and Miranda Hardie and Peter Harrigan and Brett McFadyen and Sharon Micallef and Michael Parr and Anna Boase and Judi Tai and Anthony Williams and Louise Cole and Ian Seppelt and Leonie Weisbrodt and Sarah Whereat and Annette Flanagan and Janet Liang and Frances Bass and Michelle Campbell and Naomi Hammond and Lisa Nicholson and Yahya Shehabi and Jonathan Foote and Sandra Peake and Patricia Williams and Renae Deans and Cheryl Fourie and Melissa Lassig-Smith and Jeffrey Lipman and Janine Stuart and Anthony Bell and Tanya Field and Richard McAllister and Kathryn Marsden and Andrew Turner and Susan Ankers and Simon Bird and Simon Finfer and Richard Lee and Anne O{\textquoteright}Connor and Julie Potter and Naresh Ramakrishnan and Ray Raper and Vanessa Dhiacou and Kathryn Girling and Alina Jovanovska and Nicole Groves and Jenny Holmes and John Santamaria and Roger Smith and Stuart Baker and Brigit Roberts and Lynne Andrews and Richard Dinsdale and Rosemary Fenton and Diane Mackle and Sarah Mortimer and Craig French and Heike Raunow and Michelle Gales and Francisco Hill and Sundaram Rachakonda and Darren Rogan and Christine Allsop and Alisa Higgins and Dinesh Varma and Kevin Champagne and Christopher Doig and Linda Knox and Pauline Taylor and Crystal Wilson and John Drover and Sharlene Hammond and Elizabeth Mann and Monica Myers and Amber Robinson and Johanne Harvey and Yoanna Skrobik and Anita Baumgartner and Laurie Meade and Nicholas Vlahakis and Cheryl Ethier and Marnie Kramer-Kile and Sangeeta Mehta and Claude Gaudert and Salmaan Kanji and Tracy McArdle and Irene Watpool and France Clark and Deborah Cook and Andrea Tkaczyk and John Marshall and Jeanna Morrissey and Orla Smith and Kerri Porretta and Victoria Wen and Ashley, {Betty Jean} and Sheilagh Mans and Boris Bojilov and Karen Code and Robert Fowler and Nicole Marinoff and Leslie Chu and John Granton and Margaret McGrath-Chong and Marilyn Steinberg and Niall Ferguson and Stephanie Go and Andrea Matte and Jonathan Rosenberg and James Stevenson and Michael Jacka and Leeca Sonnema and Roger Autio and Angela Brevner and Dean Chittock and Dara Davies and Pia Ganz and Maureen Gardner and Susan Logie and Laurie Smith and Leslie Atkins and Fiona Auld and Marni Stewart and Gordon Wood",

year = "2015",

month = jun,

day = "25",

doi = "10.1007/s00134-015-3757-6",

language = "English",

volume = "41",

pages = "1037--1047",

journal = "Intensive Care Medicine",

issn = "0342-4642",

publisher = "Springer-VDI-Verlag GmbH & Co. KG",

number = "6",

}

The NICE-SUGAR Study Investigators for the ANZ Intensive Care Society Clinical Trials Group and the Canadian Critical Care Trials Group, Foster, D, Dhingra, V, Bellomo, R, Cook, D, Dodek, P, Hebert, P, Henderson, W, Myburgh, J, Blair, D, Norton, R, Heyland, D, McDonald, E, Ronco, J, Peto, R, Sandercock, P, Sprung, C, Young, JD, Li, Y, Li, Q, Bompoint, S, Billot, L, Crampton, L, Darcy, F, Jayne, K, Kumarasinghe, V, Little, L, McEvoy, S, MacMahon, S, Pandey, S, Ryan, S, Shukla, R, Vijayan, B, Robinson, B, Atherton, S, Bell, J, Hadfield, L, Hourigan, C, McArthur, C, Newby, L, Simmonds, C, Buhr, H, Eccleston, M, McGuinness, S, Parke, R, Bellomo, R, Bates, S, Goldsmith, D, Mercer, I, O’Sullivan, K, Gazzard, R, Hill, D, Tauschke, C, Ghelani, D, Nand, K, Reece, G, Sara, T, Elliott, S, Ernest, D, Hamilton, A, Ashley, R, Bailey, A, Crowfoot, E, Gissane, J, Mitchell, I, Ranse, J, Whiting, J, Douglas, K, Milliss, D, Tan, J, Wong, H, Blythe, D, Palermo, A, Hardie, M, Harrigan, P, McFadyen, B, Micallef, S, Parr, M, Boase, A, Tai, J, Williams, A, Cole, L, Seppelt, I, Weisbrodt, L, Whereat, S, Flanagan, A, Liang, J, Bass, F, Campbell, M, Hammond, N, Nicholson, L, Shehabi, Y, Foote, J, Peake, S, Williams, P, Deans, R, Fourie, C, Lassig-Smith, M, Lipman, J, Stuart, J, Bell, A, Field, T, McAllister, R, Marsden, K, Turner, A, Ankers, S, Bird, S, Finfer, S, Lee, R, O’Connor, A, Potter, J, Ramakrishnan, N, Raper, R, Dhiacou, V, Girling, K, Jovanovska, A, Groves, N, Holmes, J, Santamaria, J, Smith, R, Baker, S, Roberts, B, Andrews, L, Dinsdale, R, Fenton, R, Mackle, D, Mortimer, S, French, C, Raunow, H, Gales, M, Hill, F, Rachakonda, S, Rogan, D, Allsop, C, Higgins, A, Varma, D, Champagne, K, Doig, C, Knox, L, Taylor, P, Wilson, C, Drover, J, Hammond, S, Mann, E, Myers, M, Robinson, A, Harvey, J, Skrobik, Y, Baumgartner, A, Meade, L, Vlahakis, N, Ethier, C, Kramer-Kile, M, Mehta, S, Gaudert, C, Kanji, S, McArdle, T, Watpool, I, Clark, F, Cook, D, Tkaczyk, A, Marshall, J, Morrissey, J, Smith, O, Porretta, K, Wen, V, Ashley, BJ, Mans, S, Bojilov, B, Code, K, Fowler, R, Marinoff, N, Chu, L, Granton, J, McGrath-Chong, M, Steinberg, M, Ferguson, N, Go, S, Matte, A, Rosenberg, J, Stevenson, J, Jacka, M, Sonnema, L, Autio, R, Brevner, A, Chittock, D, Davies, D, Ganz, P, Gardner, M, Logie, S, Smith, L, Atkins, L, Auld, F, Stewart, M & Wood, G 2015, 'Intensive versus conventional glucose control in critically ill patients with traumatic brain injury: long-term follow-up of a subgroup of patients from the NICE-SUGAR study', Intensive Care Medicine, vol. 41, no. 6, pp. 1037-1047. https://doi.org/10.1007/s00134-015-3757-6

Intensive versus conventional glucose control in critically ill patients with traumatic brain injury: long-term follow-up of a subgroup of patients from the NICE-SUGAR study. / The NICE-SUGAR Study Investigators for the ANZ Intensive Care Society Clinical Trials Group and the Canadian Critical Care Trials Group; Foster, Denise; Dhingra, Vinay et al.
In: Intensive Care Medicine, Vol. 41, No. 6, 25.06.2015, p. 1037-1047.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Intensive versus conventional glucose control in critically ill patients with traumatic brain injury

T2 - long-term follow-up of a subgroup of patients from the NICE-SUGAR study

AU - The NICE-SUGAR Study Investigators for the ANZ Intensive Care Society Clinical Trials Group and the Canadian Critical Care Trials Group

AU - Foster, Denise

AU - Dhingra, Vinay

AU - Bellomo, Rinaldo

AU - Cook, Deborah

AU - Dodek, Peter

AU - Hebert, Paul

AU - Henderson, William

AU - Myburgh, John

AU - Blair, Deborah

AU - Norton, Robyn

AU - Heyland, Daren

AU - McDonald, Ellen

AU - Ronco, Juan

AU - Peto, Richard

AU - Sandercock, Peter

AU - Sprung, Charles

AU - Young, J. Duncan

AU - Li, Yang

AU - Li, Qiang

AU - Bompoint, Severine

AU - Billot, Laurent

AU - Crampton, Leonie

AU - Darcy, Fotios

AU - Jayne, Kathy

AU - Kumarasinghe, Viraji

AU - Little, Lorraine

AU - McEvoy, Suzanne

AU - MacMahon, Stephen

AU - Pandey, Sameer

AU - Ryan, Suzanne

AU - Shukla, Ravi

AU - Vijayan, Bala

AU - Robinson, Bruce

AU - Atherton, Susan

AU - Bell, Jeanette

AU - Hadfield, Louise

AU - Hourigan, Craig

AU - McArthur, Colin

AU - Newby, Lynette

AU - Simmonds, Catherine

AU - Buhr, Heidi

AU - Eccleston, Michelle

AU - McGuinness, Shay

AU - Parke, Rachael

AU - Bellomo, Rinaldo

AU - Bates, Samantha

AU - Goldsmith, Donna

AU - Mercer, Inga

AU - O’Sullivan, Kim

AU - Gazzard, Robert

AU - Hill, Dianne

AU - Tauschke, Christine

AU - Ghelani, Dhawal

AU - Nand, Kiran

AU - Reece, Graham

AU - Sara, Treena

AU - Elliott, Suzanne

AU - Ernest, David

AU - Hamilton, Angela

AU - Ashley, Rebecca

AU - Bailey, Andrew

AU - Crowfoot, Elise

AU - Gissane, Jelena

AU - Mitchell, Imogen

AU - Ranse, Jamie

AU - Whiting, Joy

AU - Douglas, Kristina

AU - Milliss, David

AU - Tan, Jeff

AU - Wong, Helen

AU - Blythe, David

AU - Palermo, Annemarie

AU - Hardie, Miranda

AU - Harrigan, Peter

AU - McFadyen, Brett

AU - Micallef, Sharon

AU - Parr, Michael

AU - Boase, Anna

AU - Tai, Judi

AU - Williams, Anthony

AU - Cole, Louise

AU - Seppelt, Ian

AU - Weisbrodt, Leonie

AU - Whereat, Sarah

AU - Flanagan, Annette

AU - Liang, Janet

AU - Bass, Frances

AU - Campbell, Michelle

AU - Hammond, Naomi

AU - Nicholson, Lisa

AU - Shehabi, Yahya

AU - Foote, Jonathan

AU - Peake, Sandra

AU - Williams, Patricia

AU - Deans, Renae

AU - Fourie, Cheryl

AU - Lassig-Smith, Melissa

AU - Lipman, Jeffrey

AU - Stuart, Janine

AU - Bell, Anthony

AU - Field, Tanya

AU - McAllister, Richard

AU - Marsden, Kathryn

AU - Turner, Andrew

AU - Ankers, Susan

AU - Bird, Simon

AU - Finfer, Simon

AU - Lee, Richard

AU - O’Connor, Anne

AU - Potter, Julie

AU - Ramakrishnan, Naresh

AU - Raper, Ray

AU - Dhiacou, Vanessa

AU - Girling, Kathryn

AU - Jovanovska, Alina

AU - Groves, Nicole

AU - Holmes, Jenny

AU - Santamaria, John

AU - Smith, Roger

AU - Baker, Stuart

AU - Roberts, Brigit

AU - Andrews, Lynne

AU - Dinsdale, Richard

AU - Fenton, Rosemary

AU - Mackle, Diane

AU - Mortimer, Sarah

AU - French, Craig

AU - Raunow, Heike

AU - Gales, Michelle

AU - Hill, Francisco

AU - Rachakonda, Sundaram

AU - Rogan, Darren

AU - Allsop, Christine

AU - Higgins, Alisa

AU - Varma, Dinesh

AU - Champagne, Kevin

AU - Doig, Christopher

AU - Knox, Linda

AU - Taylor, Pauline

AU - Wilson, Crystal

AU - Drover, John

AU - Hammond, Sharlene

AU - Mann, Elizabeth

AU - Myers, Monica

AU - Robinson, Amber

AU - Harvey, Johanne

AU - Skrobik, Yoanna

AU - Baumgartner, Anita

AU - Meade, Laurie

AU - Vlahakis, Nicholas

AU - Ethier, Cheryl

AU - Kramer-Kile, Marnie

AU - Mehta, Sangeeta

AU - Gaudert, Claude

AU - Kanji, Salmaan

AU - McArdle, Tracy

AU - Watpool, Irene

AU - Clark, France

AU - Cook, Deborah

AU - Tkaczyk, Andrea

AU - Marshall, John

AU - Morrissey, Jeanna

AU - Smith, Orla

AU - Porretta, Kerri

AU - Wen, Victoria

AU - Ashley, Betty Jean

AU - Mans, Sheilagh

AU - Bojilov, Boris

AU - Code, Karen

AU - Fowler, Robert

AU - Marinoff, Nicole

AU - Chu, Leslie

AU - Granton, John

AU - McGrath-Chong, Margaret

AU - Steinberg, Marilyn

AU - Ferguson, Niall

AU - Go, Stephanie

AU - Matte, Andrea

AU - Rosenberg, Jonathan

AU - Stevenson, James

AU - Jacka, Michael

AU - Sonnema, Leeca

AU - Autio, Roger

AU - Brevner, Angela

AU - Chittock, Dean

AU - Davies, Dara

AU - Ganz, Pia

AU - Gardner, Maureen

AU - Logie, Susan

AU - Smith, Laurie

AU - Atkins, Leslie

AU - Auld, Fiona

AU - Stewart, Marni

AU - Wood, Gordon

PY - 2015/6/25

Y1 - 2015/6/25

N2 - Purpose: To compare the effect of intensive versus conventional blood glucose control in patients with traumatic brain injury. Methods: In a large international randomized trial patients were randomly assigned to a target blood glucose (BG) range of either 4.5–6.0 mmol/L (intensive control) or <10 mmol/L (conventional control). Patients with traumatic brain injury (TBI) were identified at randomization and data were collected to examine the extended Glasgow outcome score (includes mortality) at 24 months. Results: Of the 6104 randomized patients, 391 satisfied diagnostic criteria for TBI; 203 (51.9 %) were assigned to intensive and 188 (48.1 %) to conventional control; the primary outcome was available for 166 (81.8 %) and 149 (79.3 %) patients, respectively. The two groups had similar baseline characteristics. At 2 years 98 (58.7 %) patients in the intensive group and 79 (53.0 %) in the conventional group had a favorable neurological outcome (odds ratio [OR] 1.26, 95 % CI 0.81–1.97; P = 0.3); 35 patients (20.9 %) in the intensive group and 34 (22.8 %) in the conventional group had died (OR 0.90, 95 % CI 0.53–1.53; P = 0.7); moderate hypoglycemia (BG 2.3–3.9 mmol/L; 41–70 mg/dL) occurred in 160/202 (79.2 %) and 17/188 (9.0 %), respectively (OR 38.3, 95 % CI 21.0–70.1; P < 0.0001); severe hypoglycemia (BG ≤ 2.2 mmol/L; ≤40 mg/dL) in 10 (4.9 %) and 0 (0.0 %), respectively (OR 20.5 95 % CI 1.2–351.6, P = 0.003). Conclusion: Although patients with traumatic brain injury randomly assigned to intensive compared to conventional glucose control experienced moderate and severe hypoglycemia more frequently, we found no significant difference in clinically important outcomes.

AB - Purpose: To compare the effect of intensive versus conventional blood glucose control in patients with traumatic brain injury. Methods: In a large international randomized trial patients were randomly assigned to a target blood glucose (BG) range of either 4.5–6.0 mmol/L (intensive control) or <10 mmol/L (conventional control). Patients with traumatic brain injury (TBI) were identified at randomization and data were collected to examine the extended Glasgow outcome score (includes mortality) at 24 months. Results: Of the 6104 randomized patients, 391 satisfied diagnostic criteria for TBI; 203 (51.9 %) were assigned to intensive and 188 (48.1 %) to conventional control; the primary outcome was available for 166 (81.8 %) and 149 (79.3 %) patients, respectively. The two groups had similar baseline characteristics. At 2 years 98 (58.7 %) patients in the intensive group and 79 (53.0 %) in the conventional group had a favorable neurological outcome (odds ratio [OR] 1.26, 95 % CI 0.81–1.97; P = 0.3); 35 patients (20.9 %) in the intensive group and 34 (22.8 %) in the conventional group had died (OR 0.90, 95 % CI 0.53–1.53; P = 0.7); moderate hypoglycemia (BG 2.3–3.9 mmol/L; 41–70 mg/dL) occurred in 160/202 (79.2 %) and 17/188 (9.0 %), respectively (OR 38.3, 95 % CI 21.0–70.1; P < 0.0001); severe hypoglycemia (BG ≤ 2.2 mmol/L; ≤40 mg/dL) in 10 (4.9 %) and 0 (0.0 %), respectively (OR 20.5 95 % CI 1.2–351.6, P = 0.003). Conclusion: Although patients with traumatic brain injury randomly assigned to intensive compared to conventional glucose control experienced moderate and severe hypoglycemia more frequently, we found no significant difference in clinically important outcomes.

KW - Blood glucose

KW - Brain injury

KW - Hypoglycemia

KW - Randomized trial

KW - Treatment outcome

UR - http://www.scopus.com/inward/record.url?scp=84933278033&partnerID=8YFLogxK

U2 - 10.1007/s00134-015-3757-6

DO - 10.1007/s00134-015-3757-6

M3 - Article

C2 - 26088909

AN - SCOPUS:84933278033

SN - 0342-4642

VL - 41

SP - 1037

EP - 1047

JO - Intensive Care Medicine

JF - Intensive Care Medicine

IS - 6

ER -

The NICE-SUGAR Study Investigators for the ANZ Intensive Care Society Clinical Trials Group and the Canadian Critical Care Trials Group, Foster D, Dhingra V, Bellomo R, Cook D, Dodek P et al. Intensive versus conventional glucose control in critically ill patients with traumatic brain injury: long-term follow-up of a subgroup of patients from the NICE-SUGAR study. Intensive Care Medicine. 2015 Jun 25;41(6):1037-1047. doi: 10.1007/s00134-015-3757-6

Intensive versus conventional glucose control in critically ill patients with traumatic brain injury: long-term follow-up of a subgroup of patients from the NICE-SUGAR study

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