• J-C Orban, A Scarlatti, J-Y Lefrant, N Molinari, M Leone, S Jaber, J-M Constantin, B Allaouchiche, and C Ichai.
• Réanimation médicochirurgicale, hôpital Saint-Roch, CHU de Nice, rue Pierre-Dévoluy, 06006 Nice cedex, France. orban.jc@chu-nice.fr
• Ann Fr Anesth Reanim. 2013 Feb 1;32(2):84-8.

IntroductionThe interest of tight glucose control in ICU is still debated. In France, no data are available regarding this therapy and the implementation of its guidelines.Study DesignSub-study of a one-day audit performed between January and May 2009.Patients And MethodsDuring a one-day audit performed in 66 ICUs, trained residents collected data regarding the presence of a formal glucose control protocol and its practical application.ResultsA formalized glucose control protocol was found in 88% of patients. During the day before the audit, 3645 glycemia measurements were performed accounting for six measurements [4-9] per patient with a median higher value of 1.6 [1.4-2.1]. Hypoglycemia (<0.8 g/L) and hyperglycemia (>1.4 g/L in non-diabetic and >1.8 g/L in diabetic patients) were found in 81 (15%) and 326 (58%) patients respectively. Two episodes (0.36%) of severe hypoglycemia (<0.4 g/L) were reported. Factors associated with glucose control protocol application were: a high SOFA score, cardioversion, mechanical ventilation, intracranial pressure monitoring, steroid use and nurse to patient ratio less than 1/2.5. Hepatic failure was the only factor associated with hypoglycemia.DiscussionGlucose control protocols are available in more than 80% ICUs but their implementation is still imperfect. However, the median glycemia meets international current recommendations. Severe hypoglycemia is a very rare event in ICU.Copyright © 2012 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

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