gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

Article

Send article

Intensive Insulin therapy in patients with severe head injury; role and possible effects

Meeting Abstract

Search Medline for

  • Christof Renner - Städtisches Klinikum Dessau, Dessau-Roßlau, Deutschland
  • Martina Boetel - Rosenheim, Deutschland
  • Sven Bercker - Leipzig, Deutschland
  • Frank Hokema - Leipzig, Deutschland
  • Jürgen Meixensberger - Leipzig, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocDI.09.06

doi: 10.3205/17dgnc233, urn:nbn:de:0183-17dgnc2330

Published: June 9, 2017

© 2017 Renner et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: The role of Intensive Insulin Therapy (IIT) in patients with neurotrauma is unclear. Purpose of this study was to evaluate the effects of intensive insulin therapy in patients with severe head injury especially possible effects of intracranial pressure.

Methods: It was a single center non randomized study. Patients with intensive insulin therapy were prospective evaluated (IITG) und compared with patients of a historical controlgroup where only strong hyperglycemia (>10 mmol/l) was treated (CTG). Patients of both groups were matched for statistical analysis. Blood glucose levels and ICP-levels were registered over the time and shown as an Area under the Curve (AUC). SAPS II-Score, number of decompressive craniectomies, duration of ventilation, duration until oral feeding, duration on ICU, rates of infection, GOS and mRS were analyzed and compared.

Results: 130 patients were included, thus 65 patients of each group were matched. Rates of infection and duration until oral feeding were significant better in the IITG. The ICP-courses, number of decompressive craniectomies and GOS / mRS showed a positive trend in the IITG. Furthermore patients with an initial better neurologic score showed significant worse ICU-courses in case of hyperglycemia.

Conclusion: Intensive insulin therapy might have positiv effects in patients with severe head injury. Especially the ICP-courses and patients with an initial better neurologic state seem to profit from intensive insulin therapy. Further evaluation should be initiated.