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First week without IV feed on intensive care results in better blood glucose control | UZ Leuven
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The need to adjust blood glucose levels with an insuline pump appears less big when patients did not receive IF feed early on. " /> <meta property="og:description" content="A large comparative study confirms it is not a good idea to start IV feed too quickly to patients during their first week on intensive care. The need to adjust blood glucose levels with an insuline pump appears less big when patients did not receive IF feed early on. 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The need to adjust blood glucose levels with an insuline pump appears less big when patients did not receive IF feed early on. </div> </div> </header> <div class="l-content"> <article class="l-content__cbs "> <div class="cbs "> <div id="420c13a7-99af-48ea-bcd0-b3397c8ce018" class="block--text text"> <p>The new multicentric and randomised study under the supervision of prof. dr. Greet Van den Berghe and prof. dr. Jan Gunst (UZ Leuven) gives hospitals an additional argument not to start IV feed too quickly in patients on intensive care. In 2001, 2006 and 2009 professor Van den Berghe's research team already published studies that showed how important it is to keep the blood glucose levels of patients on intensive care stable: their chance of organ failure and the risk of death on intensive care were significantly smaller when blood glucose levels remained on a normal level. The principle of keeping blood glucose levels on a normal level with close follow-up and an insulin pump was then adopted by quite a number of centred worldwide. </p> <p>At UZ Leuven it has become standard practice since 2001 to make sure that critically ill patients have stable and normal blood glucose levels. UZ Leuven has since developed an excellent computer algorithm to keep blood glucose levels normal without low values or big fluctuations in blood glucose.</p> </div> <blockquote class="quote" id="by-not-giving-artificial-nutrition-we-see-far-fewer-high-spikes-in-blood-sugar-levels-this-is-better-for-survival-and-makes-for-a-faster-recovery-for-the-patient"> <div class="quote__content "> <svg class="quote__quotemark" width="50" height="36" xmlns="http://www.w3.org/2000/svg"><path d="M10.976 13.09c6.034 0 10.926 5.13 10.926 11.455C21.902 30.872 17.01 36 10.976 36 4.94 36 .049 30.872.049 24.545L0 22.91C0 10.257 9.784 0 21.854 0v6.545c-4.17 0-8.09 1.703-11.038 4.793a16.413 16.413 0 0 0-1.553 1.893c.558-.092 1.13-.14 1.713-.14zm28.097 0C45.108 13.09 50 18.22 50 24.546 50 30.872 45.108 36 39.073 36c-6.034 0-10.927-5.128-10.927-11.455l-.048-1.636C28.098 10.257 37.882 0 49.95 0v6.545c-4.17 0-8.09 1.703-11.038 4.793a16.404 16.404 0 0 0-1.552 1.893c.558-.092 1.13-.14 1.712-.14z" fill="#007ACC" fill-rule="nonzero"/></svg> <div class="quote__text"> By not giving artificial nutrition, we see far fewer high spikes in blood sugar levels. This is better for survival and makes for a faster recovery for the patient </div> <img class="quote__img quote__img--no-crop" src="https://wmimages.uzleuven.be/styles/1d41396c1273794b4b4f4759cfde2dfc2f9128dd/2020-12/greet-van-den-berghe-20160202-001-e1459322586954-222x300.jpg?style=W3sianBlZyI6eyJxdWFsaXR5Ijo3NX19LHsicmVzaXplIjp7ImZpdCI6ImNvdmVyIiwid2lkdGgiOjI0MCwiaGVpZ2h0IjoyNDAsImdyYXZpdHkiOiJjZW50ZXIiLCJ3aXRob3V0RW5sYXJnZW1lbnQiOnRydWV9fV0=&sign=23ac79b5895cd76fe1195132dde5a7a4b663c57e31b528093b9c9130557f5baf" /> <div class="quote__source">prof. dr. Greet Van den Berghe</div> </div> </blockquote> <div id="088b44d7-7a52-443c-a3b2-c70bf75c3f83" class="block--text text"> <h2 id="fewer-fluctuations-in-blood-glucose-level">Fewer fluctuations in blood glucose level</h2> <p>A new study now show that not giving IV feed in the first week of admission on intensive care makes it easier to prevent blood glucose fluctuations. That giving drip feed to critically ill patients in that initial period is not to be recommeded, had already been proven extensively by UZ Leuven studies in 2011 and 2016. UZ Leuven and many other hospitals now wait a week before starten IF feed to patients in intensive care. </p> <p><strong>Prof. dr. Greet Van den Berghe, </strong>head of the intensive medicine department at UZ Leuven: “However, we do notice there are still hospitals that still give IV feed to critically ill patients during their first week on intensive care. Our new study, carried out in as many as 9,230 patients, gives a convincing additional argument to not do this anymore: the need for follow-up and adjustment of blood glucose level decreases when patients are not given IV feed during the first week. This is only logical: artificial feeding in your bloodstream raises blood sugar levels very much. As a result we need to bring it down again with an insulin drip. If we don't administer artificial feeding in an early stage, we see far fewer high spikes in blood sugar levels. This new study now shows that it therefore also less necessary to strictly normalise blood glucose levels. Not giving IV feed in an early stage prevents very high blood glucose levels, which is better for the patient's recovery and his survival rate.”</p> <p>The Leuven intensive care specialists also advise against other medication that can severely disrupt blood glucose levels, but confirm that for some patients there is no other way. "If you do have to administer insulin to critically ill patients, has to make sure there are well-trained doctors and nurses that will proceed with extreme care. A good algorithm and a waterproof protocol will make sure blood glucose levels are kept under control and the chance of complications in critically ill patients is kept to a minimum.” </p> <p><em>The <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2304855?query=featured_home" target="_blank" rel="noreferrer noopener">study</a>, performed in colloboration with UZ Gent and Jessa Hospital Hasselt was recently published in the New England Journal Of Medicine.</em></p> </div> <div class="section section--two" data-content-loader=""> <div class="section__heading"> <h2 class="" id="special"> <span>Special</span> </h2> </div> <div class="section__content" data-content-loader-container=""> <div class="card is-link" href="/en/physicians-and-specialists/jan-gunst" target="" rel=""> <img class="card__image" width="90" height="120" src="https://wmimages.uzleuven.be/styles/0967241a026ba006f8b1a5a2381dc96ba24dca27/2019-10/505046.jpeg?style=W3sianBlZyI6eyJxdWFsaXR5Ijo3NX19LHsicmVzaXplIjp7ImZpdCI6ImNvdmVyIiwid2lkdGgiOjE4MCwiaGVpZ2h0IjoyNDAsImdyYXZpdHkiOiJjZW50ZXIiLCJ3aXRob3V0RW5sYXJnZW1lbnQiOmZhbHNlfX1d&sign=fd8f9364516f3be5e4f33e4bb9a57f1caebb2c3bf989805161b52f31d88b7956" /> <div class="card__content"> <a href="/en/physicians-and-specialists/jan-gunst" class="teaser__title heading-3 teaser__title--is-link"> <span>Gunst Jan, </span> <span>prof. dr.<span style="margin-left: 5px"><div class="teaser__arrow"> <svg width="18" height="18" viewBox="0 0 18 18" fill="none" xmlns="http://www.w3.org/2000/svg"> <circle cx="9" cy="9" r="8" transform="rotate(-90 9 9)" stroke="currentColor" stroke-width="1.5" stroke-linecap="square"/> <path d="M9 12.2L12.2 9L9 5.8" stroke="currentColor" stroke-width="1.5" stroke-linecap="square"/> <path d="M4.79999 9H11.8" stroke="currentColor" stroke-width="1.5"/> </svg> </div> </span></span> </a> <div class="card__subtitle meta">Intensivist</div> </div> </div> <div class="card is-link" href="/en/physicians-and-specialists/greet-van-den-berghe" target="" rel=""> <img class="card__image" width="90" height="120" src="https://wmimages.uzleuven.be/styles/0967241a026ba006f8b1a5a2381dc96ba24dca27/2019-10/203657.jpeg?style=W3sianBlZyI6eyJxdWFsaXR5Ijo3NX19LHsicmVzaXplIjp7ImZpdCI6ImNvdmVyIiwid2lkdGgiOjE4MCwiaGVpZ2h0IjoyNDAsImdyYXZpdHkiOiJjZW50ZXIiLCJ3aXRob3V0RW5sYXJnZW1lbnQiOmZhbHNlfX1d&sign=f536af487c270550a8ece9bc7d11d7d8c3ff81c7c831764c98329b5af6a129f4" /> <div class="card__content"> <a href="/en/physicians-and-specialists/greet-van-den-berghe" class="teaser__title heading-3 teaser__title--is-link"> <span>Van den Berghe Greet, </span> <span>prof. dr.<span style="margin-left: 5px"><div class="teaser__arrow"> <svg width="18" height="18" viewBox="0 0 18 18" fill="none" xmlns="http://www.w3.org/2000/svg"> <circle cx="9" cy="9" r="8" transform="rotate(-90 9 9)" stroke="currentColor" stroke-width="1.5" stroke-linecap="square"/> <path d="M9 12.2L12.2 9L9 5.8" stroke="currentColor" stroke-width="1.5" stroke-linecap="square"/> <path d="M4.79999 9H11.8" stroke="currentColor" stroke-width="1.5"/> </svg> </div> </span></span> </a> <div class="card__subtitle meta">Intensivist</div> </div> </div> </div> </div> <div class="message is-default is-year-report"> <div class="message__content"> <h3 class="message__title">This article is part of the Annual report 2023</h3> <ul class="list is-styled"> <li><a href="/en/annual-reports/annual-report-2023/news/leuven-surgeons-transplant-four-organs-during-one-procedure">Leuven surgeons transplant four organs during one procedure in a toddler</a></li> <li><a href="/en/annual-reports/annual-report-2023/news/uz-leuven-helps-build-climate-neutral-leuven">UZ Leuven helps build a climate-neutral Leuven</a></li> <li><a href="/en/annual-reports/annual-report-2023/news/uz-leuven-recognised-first-forensic-medical-institute-our">UZ Leuven 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