Application of conventional blood glucose control strategy in surgical ICU in developing countries: Is it beneficial?

Peer review under responsibility of Egyptian Society of Anesthesiologists.

Figures & data

igure 1 Incidence of mortality in group I and group II. Causes of mortality in group I (intensive treatment group) included sepsis, myocardial infarction, hypovolemic shock and Central nervous system (CNS) catastrophe with an incidence of 70%, 10%, 10% and 10% respectively of mortality cases, while in group II (conventional treatment group) causes of mortality included sepsis, respiratory failure and CNS catastrophe with an incidence of 55%, 33% and 11% respectively of mortality cases.

igure 2 Percentage of hypoglycemia in group I and group II. Incidence of hypoglycemia was 29% in group I (intensive treatment group), and 6% in group II (conventional treatment group) with P value <0.05 which is statistically significant.

igure 3 Percentage of respiratory failure in group I (intensive treatment group) and Group II (conventional treatment group). Incidence of respiratory failure in group I was 12.7% versus 10.7% in group II with P value (0.667) which is statistically insignificant.

able 2 Systolic blood pressure in group I (55 patients) and group II (65 patients). Data are represented in terms of mean ± standard deviation.

	SBP day1	SBP day2	SBP day3	SBP day4	SBP day5
Group I	124.27 ± 23.2	120 ± 23.54	116.56 ± 25.22	117.75 ± 24.63	121.92 ± 27.2
Group II	127.69 ± 22.81	124.79 ± 17.65	124.22 ± 16.27	121.5 ± 18.99	117.65 ± 18.12
P value	0.419	0.305	0.155	0.593	0.63

Group I (intensive treatment group), Group II (conventional treatment group), SBP (systolic blood pressure), and P value < 0.05 means significant.

able 3 Heart rate in group I (55 patients) and group II (65 patients). Data are represented in terms of mean ± standard deviation.

	HR day1	HR day2	HR day3	HR day4	HR day5
Group I	106.2 ± 16.43	104.24 ± 15.43	103.25 ± 18	106.7 ± 17.82	108.08 ± 18.43
Group II	108.98 ± 19.65	103.54 ± 14.32	99.97 ± 15.42	100.9 ± 17.37	102.24 ± 17.6
P value	0.4	0.831	0.437	0.304	0.389

Group I (intensive treatment group), Group II (conventional treatment group), HR (heart rate), and P value < 0.05 means significant.

able 4 Central venous pressure in group I (55 patients) and group II (65 patients). Data are represented in terms of mean and standard deviation.

		CVP day1	CVP day2	CVP day3	CVP day4	CVP day5
Group I	Mean ± SD	6.91 ± 4.58	8.24 ± 2.15	8.53 ± 2.53	10.7 ± 3.92	9.62 ± 3.36
Group II	Mean ± SD	7.02 ± 3.84	8.38 ± 2.36	8.44 ± 2.6	8.9 ± 3.32	10 ± 2.98
P value		0.892	0.789	0.884	0.126	0.747

Group I (intensive treatment group), Group II (conventional treatment group), CVP (central venous pressure), and P value < 0.05 means significant.

able 5 Creatinine in group I (55 patients) and group II (65 patients). Data are presented in terms of mean ± standard deviation.

	Creat day1	Creat day2	Creat day3	Creat day4	Creat day5
Group I	1.04 ± 0.34	1.15 ± 0.58	1.14 ± 0.73	1.24 ± 0.84	1.44 ± 1.16
Group II	0.99 ± 0.31	1.17 ± 0.49	1.3 ± 1.04	1.45 ± 1.2	1.7 ± 1.6
P value	0.47	0.904	0.471	0.536	0.613

Group I (intensive treatment group), Group II (conventional treatment group), creat (Creatinine), Creatinine reference range (0.6–1.3 mmol/l) and P value < 0.05 means significant.

able 6 Liver enzymes in group I (55 patients) and group II (65 patients). Data are presented in terms of mean ± standard deviation.

		Day1	Day2	Day3	Day4	Day5
Group I	ALT	64.18 ± 167.64	50.81 ± 100.73	36.09 ± 51.48	27.2 ± 9.98	26.23 ± 5.78
	AST	69.75 ± 162.3	53.76 ± 72.9	49.47 ± 68	39.05 ± 22.51	35.08 ± 6.59
Group II	ALT	54.31 ± 112.1	53.98 ± 120.1	39.25 ± 46.58	39.15 ± 33.64	33.65 ± 20.72
	AST	52.48 ± 73.09	60.63 ± 117.76	53.22 ± 60.59	62.9 ± 72	60 ± 87.05
P value (ALT)		0.711	0.895	0.798	0.142	0.176
P value (AST)		0.468	0.742	0.817	0.171	0.257

Group I (intensive treatment group), Group II (conventional treatment group), (ALT) Alanine Transferase, (AST) Aspartate Transferase., ALT reference range (30–65 mmol/l). AST reference range (15–37 mmol/l), (P value (ALT)) p value regarding Alanine Transferase between the two groups, (P value (AST)) p value regarding Aspartate Transferase between the two groups, and P value < 0.05 means significant.

There is no statistical significant change in Alanine transferase and Aspartate transferase enzymes between the two groups during the first five days of starting glycemic control.

able 7 Hemoglobin (Hb) in group I (55 patients) and group II (65 patients) in gm/dl. Data are presented in terms of mean ± standard deviation.

	Hb day1	Hb day2	Hb day3	Hb day4	Hb day5
Group I	10.12 ± 1.65	9.79 ± 1.63	9.6 ± 1.52	9.37 ± 1.2	8.67 ± 0.69
Group II	10.11 ± 2.27	9.52 ± 1.3	10.07 ± 1.69	9.62 ± 1.35	9.37 ± 1.18
P value	0.991	0.402	0.245	0.539	0.054

Group I (intensive treatment group), Group II (conventional treatment group), Hb (Hemoglobin), and P value < 0.05 means significant.

able 8 Total leukocytic count (TLC) in group I (55 patients) and group II (65 patients). Data are presented in terms of mean ± standard deviation.

	TLC day1	TLC day2	TLC day3	TLC day4	TLC day5
Group I	11320 ± 4800	11965 ± 4177	12625 ± 6163	12060 ± 5671	14125 ± 8259
Group II	12757 ± 9253	13746 ± 6193	12268 ± 5187	15094 ± 7061	15971 ± 6836
P value	0.278	0.118	0.803	0.149	0.551

Group I (intensive treatment group), Group II (conventional treatment group), TLC (total leukocytic count), P value < 0.05 means significant.

able 1 Demographic data of IIT group (55 patients, group I) and conventional group (65 patients, group II). Data are represented as mean ± standard deviation (SD) and percentage.

	Group I	Group II
Age	46.4 ± 19.03	42.17 ± 16.68	P value (0.202)
Weight in kg	76.82 ± 12.74	76 ± 12.06	P value (0.72)
Male (%)	58.18	58.46	i value (0.968)
Female (%)	41.82	41.54
Diabetic (%)	38.18	38.46	P value (0.968)
Nondiabetic (%)	61.82	61.54
APACHE II	14.07 ± 6.51	13.31 ± 6.66	P value (0.527)

APACHE II (Acute Physiology and Chronic Health Evaluation II) and P value <0.05 means significant.

able 9 ICU and total hospital stay in group I (55 patients) and group II (65 patients) in days. Data are presented in terms of mean ± standard deviation.

	Group I	Group II
ICU stay	3.76 ± 4	4.15 ± 5.52	P value (0.655)
Total hospital stay	8.6 ± 4.92	9.06 ± 5.74	P value (0.636)

Group I (intensive treatment group), Group II (conventional treatment group), (ICU) intensive care unit, and P value < 0.05 means significant.