Hyperinsulinemic Therapy in Sepsis

Hyperinsulinemic Therapy in Sepsis

Insulin regulates blood sugar and acts to suppress inflammation. Hyperinsulinemic Therapy is a protocol for Insulin administration that involves the administration of a calculated higher dose of insulin into the blood stream. This therapy is called dextrose/insulin clamp. It has been shown to be safe and successful in maintaining normal glucose levels.

The objective of the study is to assess if the clamp can achieve a steady and normal blood glucose level in patients admitted to the intensive care unit with sepsis. Furthermore, if the higher insulin dose would lead to a drop in the inflammatory response seen in septic patients.

Inclusion Criteria:

• Admission to the ICU with a diagnosis of Septic shock or Severe Sepsis.

Exclusion Criteria:

• Age less than 18 years old.
• Pregnancy.
• Patients who cannot provide informed consent and there is no surrogate decision maker.
• A delay of more than 24 hours between eligibility and randomization.
• Patients admitted to the intensive care unit for treatment of diabetic ketoacidosis or hyperosmolar state.
• Imminent death.
• Patients who the treating clinicians are not committed to full supportive care. This is confirmed by a documented treatment-limitation order that exceeds a "do-not-resuscitation" order.