Safety and efficacy of a graduated intravenous insulin infusion protocol in critically ill trauma patients receiving specialized nutritional support

Nutrition ◽  
2008 ◽  
Vol 24 (6) ◽  
pp. 536-545 ◽  
Author(s):  
Roland N. Dickerson ◽  
Cortney E. Swiggart ◽  
Laurie M. Morgan ◽  
George O. Maish ◽  
Martin A. Croce ◽  
...  
Keyword(s):  
Critically Ill ◽  
Nutritional Support ◽  
Insulin Infusion ◽  
Trauma Patients ◽  
Safety And Efficacy ◽  
Intravenous Insulin ◽  
Insulin Infusion Protocol ◽  
Infusion Protocol

Morbidity Reduction in Critically Ill Trauma Patients Through use of a Computerized Insulin Infusion Protocol: A Preliminary Study

2007 ◽  
Vol 62 (6) ◽  
pp. 1370-1376 ◽  
Author(s):  
Eric A. Toschlog ◽  
Christopher Newton ◽  
Nichole Allen ◽  
Mark A. Newell ◽  
Claudia E. Goettler ◽  
...  
Keyword(s):  
Critically Ill ◽  
Insulin Infusion ◽  
Trauma Patients ◽  
Preliminary Study ◽  
Insulin Infusion Protocol ◽  
Infusion Protocol

Abstract 3529: Feasibility, Effectiveness and Safety of Intensive Glucose Control in Critically Ill Hyperglycemic Patients Hospitalized With Acute Coronary Syndromes

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Mikhail Kosiborod ◽  
Silvio Inzucchi ◽  
Mitchell Hamburg ◽  
Lisa Riggs ◽  
Sindhu Koshy ◽  
...  
Keyword(s):  
Critically Ill ◽  
Insulin Infusion ◽  
Laboratory Data ◽  
Female Gender ◽  
Intensive Glucose Control ◽  
Post Intervention ◽  
Intravenous Insulin ◽  
Coronary Syndromes ◽  
Insulin Infusion Protocol ◽  
Infusion Protocol

Background: Elevated blood glucose (BG) is associated with higher mortality and complications in patients (pts) hospitalized with AMI. While current ACC/AHA guidelines recommend “normalization” of BG in critically ill AMI pts, experience with implementation of intensive BG control protocols in this population is extremely limited. Methods: We implemented an intensive BG control protocol at the Mid America Heart Institute (MAHI) CCU beginning 08/2006, with the purpose of evaluating its feasibility, safety and effectiveness. All ACS patients with admission BG >140 mg/dL received a modified Yale-MAHI intravenous insulin infusion protocol, with a target BG range of 90–120 mg/dL. Demographic, clinical and laboratory data were abstracted from medical records of 94 consecutive pts that received the protocol (post-intervention), and compared with data on 138 consecutive ACS pts with admission BG >140 mg/dL hospitalized in CCU immediately prior to the protocol implementation (pre-intervention). Results: There were no significant differences between pre and post-intervention pts in age (64 vs. 66, p=0.2), female gender (40 vs. 39%, p=0.8), known diabetes (57 vs. 51%, p=0.3), or admission BG (218 vs. 203 mg/dL, p=0.13). Mean 24 hour BG was markedly reduced in post-intervention vs. pre-intervention pts (132 vs. 181 mg/dL, p<0.001). The protocol was very effective in both rapid attainment and maintenance of BG targets (Figure ). The rate of hypoglycemia (BG <60 mg/dL) was 0.72%, and none of the hypoglycemic events were symptomatic. Conclusions: Intensive BG control in critically ill ACS patients with the modified Yale-MAHI protocol is feasible, effective and safe.

scholarly journals Near-Euglycemia Can Be Achieved Safely in Pediatric Total Pancreatectomy Islet Autotransplant Recipients Using an Adapted Intravenous Insulin Infusion Protocol

2014 ◽  
Vol 16 (11) ◽  
pp. 706-713 ◽  
Author(s):  
Gregory P. Forlenza ◽  
Srinath Chinnakotla ◽  
Sarah J. Schwarzenberg ◽  
Marie Cook ◽  
David M. Radosevich ◽  
...  
Keyword(s):  
Insulin Infusion ◽  
Total Pancreatectomy ◽  
Intravenous Insulin ◽  
Islet Autotransplant ◽  
Insulin Infusion Protocol ◽  
Infusion Protocol

Intravenous Insulin Infusion Protocol Compared With Subcutaneous Insulin for the Management of Hyperglycemia in Critically Ill Adults

2019 ◽  
Vol 53 (9) ◽  
pp. 894-898 ◽  
Author(s):  
Kenneth K. Tran ◽  
Jeffery L. Kibert ◽  
Evan D. Telford ◽  
Andrew J. Franck
Keyword(s):  
Insulin Infusion ◽  
Medical Center ◽  
Decision Support Tool ◽  
Clinical Decision ◽  
Lower Proportion ◽  
Insulin Regimen ◽  
Support Tool ◽  
Intravenous Insulin ◽  
Insulin Infusion Protocol ◽  
Infusion Protocol

Background: The use of an intravenous insulin infusion protocol (IIP) is recommended for management of hyperglycemia in the intensive care unit (ICU); however, limited evidence of comparison has been made with subcutaneous (SC) insulin regimens. Objective: This study aims to evaluate the safety and effectiveness of an IIP compared with SC insulin regimens in an ICU patient sample since the implementation of an IIP using a computerized clinical-decision support tool. Methods: This investigation was a retrospective cohort study of patients who were treated for hyperglycemia while admitted to any of the ICUs at a Veterans Affairs Medical Center. Patients who were treated with either an IIP or a scheduled SC insulin regimen between May 1, 2015, and May 25, 2016, were included for evaluation. Results: Blood glucose (BG) was within the normoglycemia range (70-180 mg/dL) for 63.0% of the measurements in patients treated with an IIP (n = 171) compared with 45.7% in those treated with SC insulin regimens (n = 121; P < 0.01). Overall, patients managed with an IIP had a lower proportion of hypoglycemic BG measurements (1.2% vs 2.1%, P < 0.01), a lower proportion of hyperglycemic BG measurements (35.8% vs 52.2%, P < 0.01), and a lower mean BG (172.4 vs 194.3 mg/dL, P < 0.01). Conclusion and Relevance: The results of this study suggest that an IIP in a sample of adult ICU patients was associated with better BG control and lower occurrence of hypoglycemia compared with SC insulin regimens.

Implementing an intravenous insulin infusion protocol in the intensive care unit

2007 ◽  
Vol 64 (4) ◽  
pp. 385-395 ◽  
Author(s):  
Rhonda S. Rea ◽  
Amy Calabrese Donihi ◽  
MaryBeth Bobeck ◽  
Peter Herout ◽  
Teresa P. McKaveney ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Insulin Infusion ◽  
Intravenous Insulin ◽  
Insulin Infusion Protocol ◽  
Infusion Protocol
Sign in / Sign up

Export Citation Format

Share Document