Nearly 1000 children (up to age 36 months) who were admitted to the cardiac ICU after undergoing cardiopulmonary bypass were randomized to receive either tight glycemic control with insulin or standard care. Those with diabetes were excluded.
Overall, the number of healthcare-associated infections (e.g., pneumonia, bloodstream infections) did not differ significantly between the groups. There were also no differences in 30-day or in-hospital mortality; length of ICU or hospital stay; or duration of mechanical ventilation or vasoactive support.
An NEJM editorialist argues why these findings should supersede those from a 2009 study showing a benefit with tight glycemic control. He concludes that the door “should be closed on the routine normalization of plasma glucose in critically ill adults and children.”