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SIMPLE treatments can reduce the death rate in intensive care units


Careful attention to relatively simple treatments, such as blood pressure drugs and insulin, can make a big difference in the risk of dying in the intensive care unit, researchers say.

Thursday's New England Journal of Medicine describes two studies of such treatments.

One found that patients brought to the emergency room with blood poisoning are more likely to live if their blood pressure and several other symptoms are treated immediately, before they go to the ICU.

The early treatment to get blood pressure and the amount of oxygen in the blood to normal cut the number of deaths from the blood infections, called sepsis, by about one-third.

The study of 263 patients was conducted at Henry Ford Hospital in Detroit.

The other study, conducted by doctors at Catholic University of Leuven in Belgium, found that surgical patients in the ICU do better if intensive insulin therapy is used to keep their blood sugar in the ideal range.

This approach is not just for diabetics. High blood sugar and insulin resistance are common in critically ill patients, diabetic or not.

Dr. Timothy W. Evans of Royal Brompton Hospital in London wrote in an accompanying editorial that the sort of therapy in the Detroit study should be started as early as possible when patients arrive with sepsis or similar symptoms. But he said it is too early to apply the insulin approach to non-surgical patients and others.
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