gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Intensified insulin therapy and infection in patients with severe injury to the CNS

Einfluss der intensivierten Insulintherapie auf Infektionen bei Patienten mit schweren Verletzungen des ZNS

Meeting Abstract

  • S. Bertig - Neurochirurgische Klinik der RWTH Aachen
  • corresponding author F.-J. Hans - Neurochirurgische Klinik der RWTH Aachen
  • G. Schälte - Anästhesiologische Klinik der RWTH Aachen
  • S. Tomé - Neurochirurgische Klinik der RWTH Aachen
  • A. Fey - Neurochirurgische Klinik der RWTH Aachen
  • E. Uhl - Neurochirurgische Klinik der LMU München

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc09.05.-13.01

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0058.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Bertig et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

In a previous study with intensive care patients suffering predominantly from cardiovascular disease requiring prolonged mechanical ventilation the implementation of intensified insulin therapy reduced the need for antibiotics and decrease the number of septicemias. Aim of the current study was to compare the influence of intensified insulin therapy on inflammatory parameters and the need for antibiotic therapy in patients with severe injury to the CNS.

Methods

Prospective randomised study of patients with CNS injury requiring mechanical ventilatory support for at least 24h. After informed consent was obtained patients were assigned to the intensified insulin therapy (glucose 80-120 mg/dl) and a standard regimen (180-220 mg/dl). Using a standardised treatment protocol blood glucose levels were kept within the desired limits. C reactive protein (CRP), procalcitonin (PCT) and leukocyte count were assessed daily. Additional parameters such as IL-6 were measured every third day. Furthermore the number of antibiotics as well as the duration of their administration was assessed in both groups.

Results

So far a total of 108 patients could be included in the study. 52 patients were assigned to the standard group (STD), 56 patients to the intensified group (INT). Mean CRP was 90.9±40.0 mg/L in STD and 87.3±42.9mg/L in INT, PCT was 0.7±1.9 and 1.0±2.1 respectively. Leukocytes count did not differ in both groups (STD:12.5±0.5, INT: 12.6±6.7 G/L). In both groups a mean number of 2 different antibiotics was given with a median total duration of 13 days in the STD and 16 days in the INT.

Conclusions

In contrast to previous studies showing a significant effect of intensified insulin therapy in patients with predominantly cardiovascular disease our preliminary data seem to indicate that this effect may not be achieved in patients with injury to the CNS. The difference could be due to the different underlying disease and comorbidity in both patient populations.