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Strict glycemic control improves mortality and morbidity of patients admitted to the postoperative intensive care unit (ICU). The investigators would like to know if this therapy could improve the long term neurologic and cognitive outcomes of patients treated for acute subarachnoid hemorrhage with either a surgical or intravascular approach.
Intensive Insulin Therapy and Strict Glycemic Control (80-120 mg/dL) Versus Standard Insulin Therapy in Neurosurgical Intensive Care Patients (Subarachnoid Hemorrhage, Traumatic Brain Injury, Intracranial Expanding Lesion): Safety, and Efficacy (Mortality, Morbidity, Long Term Neurologic Outcome).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| A | Experimental | Insulin infusion rate titrated to maintain glycemia between 80 and 100 mg/dl |
|
| B | Active Comparator | Insulin infusion rate titrated to maintain glycemia between 80 and 220 mg/dl |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Insulin (Actrapid) | Drug | 50 UI Actrapid diluted in 50 ml of saline |
|
| Measure | Description | Time Frame |
|---|---|---|
| Episodes of hypoglycemia |
| Measure | Description | Time Frame |
|---|---|---|
| Infection rate | during the study | |
| Vasospasm rate | during the study | |
| Mortality |
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Inclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Federico Bilotta, MD, PhD | Contact | 39 339 33 708 22 | bilotta@tiscali.it | |
| Vincenzo Cuzzone | Contact |
| Name | Affiliation | Role |
|---|---|---|
| Federico Bilotta, MD, PhD | Department of Anesthesiology, Critical Care and Pain Medicine | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Rome La Sapienza | Recruiting | Rome | Italy |
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| ID | Term |
|---|---|
| D013345 | Subarachnoid Hemorrhage |
| D000070642 | Brain Injuries, Traumatic |
| D020300 | Intracranial Hemorrhages |
| D007003 | Hypoglycemia |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| C000006 | insulin, neutral |
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| 6 months follow up |
| Neurologic status | 6 months follow up |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D006470 | Hemorrhage |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D001930 | Brain Injuries |
| D006259 | Craniocerebral Trauma |
| D020196 | Trauma, Nervous System |
| D014947 | Wounds and Injuries |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |