Influence of different blood glucose control on prognosis of critically ill patients with lung infection and respiratory failure

Objective To explore the influence of intensive glycemic control by insulin pump on prognosis of critically ill patients with lung infection and respiratory failure.Methods In the emergency intensive care unit (EICU),200 critically ill patients with hyperglycemia (A-PACHE II score >15 ,random blood glucose > 11.1 mmol /L)were collected and randomly di-vided into the intensive insulin therapy (IIT)group and the convention insulin therapy(CIT) group(use insulin pump to control blood glucose).IIT group and CIT group included 31 cases and 33 cases of pulmonary infection and respiratory failure.Ventilator and antibiotic use days,short-term mortality (within 28 days),rate of hypoglycemia,nosocomial infection,hospital stay and hospital costs were observed and compared between two groups.Results There was no significant differences between two groups in aspects of age,sex ratio,oxygen saturation,pressure of oxygen, pressure of Carbon dioxide,pH,blood pressure,respiratory failure type,blood glucose,elec-trolytes,inflammation,heart function,liver and kidney function,fasting C peptide,HbAlc and APACHE Ⅱ score(P >0.05).APACHE II score at the time of 3 days and 7 days after admission, nosocomial infection,short-term mortality hospital day and hospital costs (P <0.05)in the IIT group were significantly lower and shorter than the CIT group.The hypoglycemia incidence rate of the IIT group was significantly higher than that of the CIT group (P <0.01).Result of serious hypoglycemia showed no significant difference between the two groups .Conclusion Strict intensive glucose control on pulmonary infection and respiratory failure may bring more benefits for acute and critically ill patients,and it can reduce the short-term mortality rate.