Impact of intensive insulin therapy on dynamic cardiac function in critically ill patients with stress-induced hyperglycemia

Table 1 Comparison of hemodynamic and biochemical parameters between the stress-induced hyperglycemia and normal glycemia groups

Parameter	SIH (n = 101)	Normal glycemia (n = 85)	t value	P value
RAP (mmHg)	9.8 ± 5.1	6.1 ± 3.5	5.659	< 0.001
PAP (mmHg)	35.2 ± 16.0	26.2 ± 10.3	4.465	< 0.001
PAWP (mmHg)	16.0 ± 7.0	8.6 ± 6.4	7.467	< 0.001
CO (L/min)	3.3 ± 2.3	6.0 ± 3.3	6.548	< 0.001
CI (L/min/m²)	1.88 ± 0.24	2.70 ± 0.50	14.61	< 0.001
BNP (pg/mL)	465.4 ± 250.0	179.5 ± 52.5	10.35	< 0.001
pH	7.41 ± 0.12	7.38 ± 0.19	1.307	0.193
PaO2 (mmHg)	52.5 ± 11.0	66.0 ± 14.3	7.271	< 0.001
PaCO2 (mmHg)	18.0 ± 6.3	37.9 ± 2.8	26.96	< 0.001

RAP: Right atrial pressure; PAP: Pulmonary artery pressure; PAWP: Pulmonary artery wedge pressure; CO: Cardiac output; CI: Cardiac index; BNP: B-type natriuretic peptide; PaO₂: Partial pressure of oxygen; PaCO₂: Partial pressure of carbon dioxide; SIH: Stress-induced hyperglycemia.

Table 2 Cardiac function and related indices before and after treatment in intensive care unit patients receiving conventional vs intensive insulin therapy (mean ± SD)

Indicator	Conventional treatment group (n = 50)	Intensive insulin therapy group (n = 51)	t value	P value
RAP (mmHg)
Before treatment	9.8 ± 3.59	9.98 ± 3.74	0.247	0.806
After treatment	8.28 ± 3.88a	7.01 ± 2.17a	2.035	< 0.05
PAP (mmHg)
Before treatment	33.5 ± 10.66	34.92 ± 10.61	0.671	0.504
After treatment	29.30 ± 6.47a	21.56 ± 3.67a	7.413	< 0.001
PAWP (mmHg)
Before treatment	16.33 ± 5.93	15.29 ± 7.49	0.773	0.442
After treatment	13.75 ± 5.26a	10.20 ± 5.35a	3.363	0.001
CO (L/min)
Before treatment	3.13 ± 1.60	3.20 ± 1.38	0.236	0.814
After treatment	3.99 ± 1.39a	4.85 ± 2.22a	2.328	0.022
CI [L/(min·m²)]
Before treatment	1.92 ± 0.24	1.96 ± 0.25	0.820	0.414
After treatment	2.11 ± 0.31a	2.58 ± 0.32a	6.700	< 0.001
BNP (pg/mL)
Before treatment	479.23 ± 184.48	452.89 ± 165.03	0.757	0.451
After treatment	345.64 ± 170.86a	202.57 ± 62.11a	5.571	< 0.001
pH
Before treatment	7.34 ± 0.11	7.37 ± 0.13	1.251	0.214
After treatment	7.46 ± 0.19	7.41 ± 0.15	1.469	0.145
PaO2 (mmHg)
Before treatment	56.80 ± 7.95	58.38 ± 8.42	0.969	0.335
After treatment	63.97 ± 10.92a	71.28 ± 11.06a	3.342	0.001
PaCO2 (mmHg)
Before treatment	19.06 ± 6.96	17.65 ± 6.47	1.055	0.294
After treatment	26.59 ± 7.85a	38.35 ± 3.63a	9.694	< 0.001

^aP < 0.05 vs the same group before treatment.

RAP: Right atrial pressure; PAP: Pulmonary artery pressure; PAWP: Pulmonary artery wedge pressure; CO: Cardiac output; CI: Cardiac index; BNP: B-type natriuretic peptide; PaCO₂: Partial pressure of carbon dioxide.

Table 3 Comparison of intensive care unit stay and clinical outcomes among three groups, n (%)

Group	ICU stay (mean ± SD)	P value	Ventilator use	P value	Mechanical ventilation time (mean ± SD, h)	P value	Mortality	P value
Conventional treatment group (n = 50)	14.5 ± 2.60a	< 0.001 vs normal	38 (76.0)a	< 0.001 vs normal	121.8 ± 15.8a	< 0.001 vs normal	21 (42.0)a	< 0.001 vs normal
Intensive insulin therapy group (n = 51)	10.3 ± 3.40a,b	< 0.001 vs normal; < 0.001 vs conv.	29 (56.9)a,b	0.0003 vs normal; 0.0419 vs conv.	82.6 ± 13.2a,b	< 0.001 vs normal; < 0.001 vs conv.	12 (23.5)a,b	0.0061 vs normal; 0.0478 vs conv.
Normal glycemia group (n = 85)	7.3 ± 3.74	-	22 (25.9)	-	59.5 ± 11.0	-	6 (7.1)	-

^aP < 0.05 vs the normal glycemia group.

^bP < 0.05 vs the conventional therapy group.

ICU: Intensive care unit.