Effect of high-dose XXXX on perioperative @entity880 levels and @entity413 control: a randomized controlled trial.

@entity1 @entity619 @entity880 @entity230 @entity413
INTRODUCTION: Blood @entity880 levels are increasingly used to monitor @entity1 . @entity230 are frequently administered to critically ill @entity1 . However, the effect of @entity230 on @entity880 levels has not been adequately investigated. We studied the effect of a single intraoperative high dose of @entity619 on @entity880 and @entity413 levels in @entity1 undergoing cardiac surgery. METHODS: The @entity619 for Cardiac Surgery (DECS) trial was a multicenter randomized trial on the effect of @entity619 1 mg/kg versus placebo on clinical outcomes after cardiac surgery in adults. Here we report a pre-planned secondary analysis of data from DECS trial @entity1 included at the University Medical Center Groningen. The use of a computer-assisted @entity413 regulation protocol-- @entity413 Regulation for Intensive care @entity1 (GRIP)--was part of routine postoperative care. GRIP aimed at @entity413 levels of 4 to 8 mmol/L. Primary outcome parameters were area under the @entity880 and @entity413 curves over the first 15 hours of ICU stay (AUC      ). ICU length of stay and mortality were observed as well. RESULTS: The primary outcome could be determined in 497 @entity1 of the 500 included @entity1 . During the first 15 hours of ICU stay, @entity880 and @entity413 levels were significantly higher in the @entity619 group than in the placebo group: @entity880 AUC       25.8 (13.1) versus 19.9 (11.2) mmol/L   *   hour, P <0.001 and @entity413 AUC       126.5 (13.0) versus 114.4 (13.9) mmol/L   *   hour, P <0.001. In this period, @entity1 in the @entity619 group required twice as much insulin compared with @entity1 who had received placebo. Multivariate and cross-correlation analyses suggest that the effect of @entity619 on @entity880 levels is related to preceding increased @entity413 levels. @entity1 in the placebo group were more likely to stay in the ICU for more than 24 hours (39.2%) compared with @entity1 in the @entity619 group (25.0%, P   =   0.001), and 30-day mortality rates were 1.6% and 2.4%, respectively (P   =   0.759). CONCLUSIONS: Intraoperative high-dose @entity619 increased postoperative @entity880 and @entity413 levels in the first 15 hours of ICU stay. Still, @entity1 in the @entity619 group had a shorter ICU length of stay and similar mortality compared with controls. TRIAL REGISTRATION: ClinicalTrials.gov NCT00293592 . Registered 16 February 2006.
