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Volume 358:2071-2075 May 8, 2008 Number 19
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Insulin and Pentastarch for Severe Sepsis

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by Brunkhorst, F. M.
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To the Editor: Brunkhorst and colleagues (Jan. 10 issue)1 report that the Efficacy of Volume Substitution and Insulin Therapy in Severe Sepsis (VISEP) study established "that intensive insulin therapy has no measurable, consistent benefit in critically ill patients" in a medical intensive care unit (ICU). This interpretation appears too conclusive, since the Supplementary Appendix of the article (available with the full text of the article at www.nejm.org) indicates that the goal of normoglycemia was reached in less than 50% of the patients in the intensive insulin-therapy group. In addition to the intrinsic properties of an intensive insulin-therapy protocol, heterogeneity in . . . [Full Text of this Article]



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