New study questions standard septic shock treatments
( dpa ) - A new study on the treatment of septic shock has cast doubt on conventional treatments such as intensive insulin therapy or the use of the synthetic fluid replacement substance pentastarch.
German researchers recruited 537 people in septic shock and randomly assigned them to receive either intensive insulin therapy or standard insulin therapy or a modified Ringer's lactate solution versus a pentastarch solution.
Pentastarch is a synthetic fluid replacement substance.
The idea behind intensive insulin therapy originally came from a study of cardiac surgical patients that found when blood sugar was kept in the normal, healthy range, mortality was reduced.
In this study, however, the German researchers found that intensive insulin therapy did not produce a statistically significant reduction in death rates but actually did increase the risk of serious adverse events, such as critically low blood sugar (hypoglycemia).
In the intensive insulin group, 17 per cent had severe hypoglycemia compared to just 4 per cent of those on standard insulin therapy.
Additionally, the researchers found that pentastarch was associated with higher rates of kidney failure than Ringer's lactate.
"The use of intensive insulin therapy placed critically ill patients with sepsis at increased risk for serious adverse events related to hypoglycemia," said one of the study's lead authors, Dr Frank Brunkhorst, a senior physician in internal and intensive care medicine at the Clinic for Anesthesiology and Intensive Care at Friedrich Schiller University of Jena in Germany.
And, he added, "As used in this study, (pentastarch) was harmful, and its toxicity increased with accumulating doses."