Tight Glycemic Control With Intensive Insulin Therapy in PICU

NCT ID: NCT00214916

Last Updated: 2022-03-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

700 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-10-31

Study Completion Date

2023-06-30

Brief Summary

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In a previous study, the investigators showed that tight blood glucose control with insulin during intensive care reduced morbidity and mortality in adult intensive care patients. Whether this intervention also improves prognosis of pediatric intensive care patients remains unknown. The current prospective, randomized, controlled study will asses the impact of intensive insulin therapy on outcome of patients in a pediatric intensive care unit. On admission patients will be randomly assigned to either strict normalization of blood glucose according age adjusted values or the conventional approach, in which insulin infusion is initiated only when blood glucose exceeds 215 mg/dl to maintain blood glucose levels between 180-200 mg/dl.

Detailed Description

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Study type: Interventional study

Study design: single centre, prospective, randomized, active control, parallel assignment, efficacy study

Conditions

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Critical Illness

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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A

conventional insulin therapy (using Actrapid IV)

Group Type ACTIVE_COMPARATOR

conventional insulin therapy (Actrapid IV only for excessive hyperglycemia)

Intervention Type DRUG

conventional insulin therapy (Actrapid IV in continuous infusion only to treat blood glucose levels exceeding 220 mg/dl)

B

intensive insulin therapy (using actrapid IV)

Group Type EXPERIMENTAL

intensive insulin therapy (Actrapid IV to normoglycemia)

Intervention Type DRUG

intensive insulin therapy (Actrapid IV in continuous infusion to age-dependent normoglycemia)

Interventions

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intensive insulin therapy (Actrapid IV to normoglycemia)

intensive insulin therapy (Actrapid IV in continuous infusion to age-dependent normoglycemia)

Intervention Type DRUG

conventional insulin therapy (Actrapid IV only for excessive hyperglycemia)

conventional insulin therapy (Actrapid IV in continuous infusion only to treat blood glucose levels exceeding 220 mg/dl)

Intervention Type DRUG

Other Intervention Names

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Actrapid IV to normoglycemia Actrapid IV only for excessive hyperglycemia

Eligibility Criteria

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Inclusion Criteria

* Children admitted to the pediatric intensive care unit and anticipated to require intensive care for at least 24 hours

Exclusion Criteria

* Expected stay \< 24 hours
* Therapy restriction upon admission
* No informed consent
* Other study enrollment
Minimum Eligible Age

1 Day

Maximum Eligible Age

16 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Greet Van den Berghe

OTHER

Sponsor Role lead

Responsible Party

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Greet Van den Berghe

Head of Dept and laboratory of Intensive Care Medicine

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Greet Van den Berghe, MD,PhD

Role: STUDY_DIRECTOR

Catholic University Leuven

Locations

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Dep Intensive Care Medicine University Hospital Leuven

Leuven, , Belgium

Site Status

Countries

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Belgium

References

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van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P, Bouillon R. Intensive insulin therapy in critically ill patients. N Engl J Med. 2001 Nov 8;345(19):1359-67. doi: 10.1056/NEJMoa011300.

Reference Type BACKGROUND
PMID: 11794168 (View on PubMed)

Verstraete S, Vanhorebeek I, Covaci A, Guiza F, Malarvannan G, Jorens PG, Van den Berghe G. Circulating phthalates during critical illness in children are associated with long-term attention deficit: a study of a development and a validation cohort. Intensive Care Med. 2016 Mar;42(3):379-392. doi: 10.1007/s00134-015-4159-5. Epub 2015 Dec 14.

Reference Type DERIVED
PMID: 26667027 (View on PubMed)

Sterken C, Lemiere J, Vanhorebeek I, Van den Berghe G, Mesotten D. Neurocognition after paediatric heart surgery: a systematic review and meta-analysis. Open Heart. 2015 Oct 29;2(1):e000255. doi: 10.1136/openhrt-2015-000255. eCollection 2015.

Reference Type DERIVED
PMID: 26568832 (View on PubMed)

Mesotten D, Gielen M, Sterken C, Claessens K, Hermans G, Vlasselaers D, Lemiere J, Lagae L, Gewillig M, Eyskens B, Vanhorebeek I, Wouters PJ, Van den Berghe G. Neurocognitive development of children 4 years after critical illness and treatment with tight glucose control: a randomized controlled trial. JAMA. 2012 Oct 24;308(16):1641-50. doi: 10.1001/jama.2012.12424.

Reference Type DERIVED
PMID: 23101118 (View on PubMed)

Gielen M, Mesotten D, Wouters PJ, Desmet L, Vlasselaers D, Vanhorebeek I, Langouche L, Van den Berghe G. Effect of tight glucose control with insulin on the thyroid axis of critically ill children and its relation with outcome. J Clin Endocrinol Metab. 2012 Oct;97(10):3569-76. doi: 10.1210/jc.2012-2240. Epub 2012 Aug 7.

Reference Type DERIVED
PMID: 22872689 (View on PubMed)

Gielen M, Mesotten D, Brugts M, Coopmans W, Van Herck E, Vanhorebeek I, Baxter R, Lamberts S, Janssen JA, Van den Berghe G. Effect of intensive insulin therapy on the somatotropic axis of critically ill children. J Clin Endocrinol Metab. 2011 Aug;96(8):2558-66. doi: 10.1210/jc.2010-3045. Epub 2011 Jun 1.

Reference Type DERIVED
PMID: 21632816 (View on PubMed)

Vlasselaers D, Mesotten D, Langouche L, Vanhorebeek I, van den Heuvel I, Milants I, Wouters P, Wouters P, Meyns B, Bjerre M, Hansen TK, Van den Berghe G. Tight glycemic control protects the myocardium and reduces inflammation in neonatal heart surgery. Ann Thorac Surg. 2010 Jul;90(1):22-9. doi: 10.1016/j.athoracsur.2010.03.093.

Reference Type DERIVED
PMID: 20609741 (View on PubMed)

Vlasselaers D, Milants I, Desmet L, Wouters PJ, Vanhorebeek I, van den Heuvel I, Mesotten D, Casaer MP, Meyfroidt G, Ingels C, Muller J, Van Cromphaut S, Schetz M, Van den Berghe G. Intensive insulin therapy for patients in paediatric intensive care: a prospective, randomised controlled study. Lancet. 2009 Feb 14;373(9663):547-56. doi: 10.1016/S0140-6736(09)60044-1. Epub 2009 Jan 26.

Reference Type DERIVED
PMID: 19176240 (View on PubMed)

Other Identifiers

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NCT00214916

Identifier Type: -

Identifier Source: secondary_id

PICU-insulin study

Identifier Type: -

Identifier Source: org_study_id

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