Agus and colleagues have made an important addition to guide the care of a select subgroup of critically ill children. Kavanagh concludes that now the door "should be closed on the routine normalization of plasma glucose in critically ill adults and children." Yet, this conclusion is based on what I believe to be an over-generalization of both the study by Agus et al. and another large pediatric critical care trial in which the populations, design, glycemic targets, and primary and critical outcomes differed greatly.1 Further, Kavanagh's interpretations of other studies involving adults appear to be flawed, since the original studies from the Catholic University of Leuven asked whether there are benefits of glycemic control, whereas the Normoglyce-mia in Intensive Care Evaluation-Survival Using Glucose Algorithm Regulation (NICE-SUGAR) study aimed to identify benefits of two rather close glycemic targets.
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