The effectiveness of intensive insulin therapy for preventing intensive care unit acquired weakness：a Meta-analysis / 重庆医学

ABSTRACT

Objective To assess the effect of the intensive insulin therapy for preventing the intensive care unit acquired weakness systematically ,in order to provide reference for making the intervention strategy .Methods We searched the database CBM ,CNKI ,WanFang Data ,VIP ,PubMed ,Cochrane Library ,EMBASE and ISI from the day of establishment to Dec 2014 to find the relevant studies with computer and by hand .Two researchers selected the studies ,evaluated the quality of the articles and ex‐tracted data according to the rigorous criterion ,then we performed the Meta‐analysis on the data with the software RevMan5 .3 .Re‐sults Three articles were enrolled ,2 788 patients in the intensive care unit were recruited ,including 1 380 patients were from the experimental group and 1 408 patients came from the controlled group .The result of the Meta‐analysis showed that compared to the conventional insulin therapy ,intensive insulin therapy reduced the incidence of intensive care unit weakness(RR= 0 .61 ,95% CI0 .42-0 .89 ,P=0 .01) ,but there was no statistical significance of it on the the intensive care unit mortality(RR=0 .74 ,95% CI0 .47-1 .17 ,P=0 .20) ,the hospital mortality(RR=0 .81 ,95% CI0 .58 -1 .13 ,P= 0 .22) ,the duration of intensive care unit stay (MD=0 ,95% CI-0 .37-0 .37 ,P=1 .00) and the duration of mechanical ventilation(MD= -1 .48 ,95% CI-3 .43-0 .47 ,P=0 .14) . Conclusion Intensive insulin therapy can reduce the incidence of intensive care unit acquired weakness ,but the effect of it on the intensive care unit mortality ,hospital mortality ,duration of intensive stay and duration of mechanical ventilation needs further research to verify .