Neither intensive insulin therapy nor the use of pentastarch as the resuscitation fluid reduces 28-day mortality or morbidity from severe sepsis. Intensive insulin therapy may cause harm because of increased hypoglycaemic episodes. Use of pentastarch increases the need for renal replacement therapy.
Level of evidence: 1+ (RCT with a low risk of bias)
References
1.
Van den BergheGWilmerAHermansGIntensive insulin therapy in the medical ICU. N Engl J Med2006;354: 449–61.
2.
Van den BergheGWoutersPWeekersFIntensive insulin therapy in critically ill patients. N Engl J Med2001;345: 1359–67.
3.
SchortgenFLacheradeJCBruneelFEffects of hydroxyethylstarch and gelatine on renal function in severe sepsis: a multicentre randomised study. Lancet2001;357: 911–16.
