Efficiency of Computerized Insulin Infusion Glucose Control in Critically Ill Patients
Purpose Intensive IV insulin infusion therapy has been applied widely to critically ill patients. However, IV insulin protocols are complex, and require repeated calculations. The purpose of this study was to evaluate the safety and efficiency of a computerized insulin infusion (CII) protocol to rep...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Society of Acute Care Surgery
2020-07-01
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| Series: | Journal of Acute Care Surgery |
| Subjects: | |
| Online Access: | http://www.jacs.or.kr/upload/pdf/jacs-2020-10-2-53.pdf |
| _version_ | 1797682288312451072 |
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| author | Hee Jung Lim Chi-Min Park Eunmi Gil Keesang Yoo Kyoung-Jin Choi Sang-Man Jin |
| author_facet | Hee Jung Lim Chi-Min Park Eunmi Gil Keesang Yoo Kyoung-Jin Choi Sang-Man Jin |
| author_sort | Hee Jung Lim |
| collection | DOAJ |
| description | Purpose Intensive IV insulin infusion therapy has been applied widely to critically ill patients. However, IV insulin protocols are complex, and require repeated calculations. The purpose of this study was to evaluate the safety and efficiency of a computerized insulin infusion (CII) protocol to replace manual insulin infusion protocols, for glucose control in critically ill patients. Methods This was an observational study (September 2016 to January 2017) of 43 patients in ICU whose blood glucose level was between 140–180 mg/mL and could not be controlled by the conventional manual insulin protocol. The CII protocol was integrated in to the electronic medical record order system, and automatically calculated the insulin infusion dose and blood sugar test (BST) interval. BSTs were taken 48 hours pre- and post-initiation of the CII protocol. The proportion of BSTs in the normal (70–180 mg/mL), hypoglycemic (70 mg/mL), and severe hyperglycemic (> 250 mg/mL) range were recorded. Results The mean number of BSTs performed before using the CII protocol was 10.3/person and 0.4/hour, and after implementing the protocol, increased to 21.7/person and 0.7/hour. The mean glucose level (281.4 mg/mL) decreased after using the CII protocol (195.5 mg/mL; p < 0.001). The percentage of BSTs within normal range increased from 22.5% to 44.9% after implementing the protocol (p < 0.001). Severe hyperglycemia (> 250 mg/mL) decreased from 47.3% to 17.9% after protocol implementation (p = 0.020). Conclusion The CII protocol safely and successfully maintained a normal glucose range, and decreased severe hyperglycemia in intensive care patients. |
| first_indexed | 2024-03-11T23:58:27Z |
| format | Article |
| id | doaj.art-cc4eb56fedb042f6b900574abd44cbdf |
| institution | Directory Open Access Journal |
| issn | 2288-5862 2288-9582 |
| language | English |
| last_indexed | 2024-03-11T23:58:27Z |
| publishDate | 2020-07-01 |
| publisher | Korean Society of Acute Care Surgery |
| record_format | Article |
| series | Journal of Acute Care Surgery |
| spelling | doaj.art-cc4eb56fedb042f6b900574abd44cbdf2023-09-18T07:14:24ZengKorean Society of Acute Care SurgeryJournal of Acute Care Surgery2288-58622288-95822020-07-01102535710.17479/jacs.2020.10.2.53193Efficiency of Computerized Insulin Infusion Glucose Control in Critically Ill PatientsHee Jung Lim0Chi-Min Park1Eunmi Gil2Keesang Yoo3Kyoung-Jin Choi4Sang-Man Jin5 Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaPurpose Intensive IV insulin infusion therapy has been applied widely to critically ill patients. However, IV insulin protocols are complex, and require repeated calculations. The purpose of this study was to evaluate the safety and efficiency of a computerized insulin infusion (CII) protocol to replace manual insulin infusion protocols, for glucose control in critically ill patients. Methods This was an observational study (September 2016 to January 2017) of 43 patients in ICU whose blood glucose level was between 140–180 mg/mL and could not be controlled by the conventional manual insulin protocol. The CII protocol was integrated in to the electronic medical record order system, and automatically calculated the insulin infusion dose and blood sugar test (BST) interval. BSTs were taken 48 hours pre- and post-initiation of the CII protocol. The proportion of BSTs in the normal (70–180 mg/mL), hypoglycemic (70 mg/mL), and severe hyperglycemic (> 250 mg/mL) range were recorded. Results The mean number of BSTs performed before using the CII protocol was 10.3/person and 0.4/hour, and after implementing the protocol, increased to 21.7/person and 0.7/hour. The mean glucose level (281.4 mg/mL) decreased after using the CII protocol (195.5 mg/mL; p < 0.001). The percentage of BSTs within normal range increased from 22.5% to 44.9% after implementing the protocol (p < 0.001). Severe hyperglycemia (> 250 mg/mL) decreased from 47.3% to 17.9% after protocol implementation (p = 0.020). Conclusion The CII protocol safely and successfully maintained a normal glucose range, and decreased severe hyperglycemia in intensive care patients.http://www.jacs.or.kr/upload/pdf/jacs-2020-10-2-53.pdfhyperglycemiahypoglycemiainsulinintensive care units |
| spellingShingle | Hee Jung Lim Chi-Min Park Eunmi Gil Keesang Yoo Kyoung-Jin Choi Sang-Man Jin Efficiency of Computerized Insulin Infusion Glucose Control in Critically Ill Patients Journal of Acute Care Surgery hyperglycemia hypoglycemia insulin intensive care units |
| title | Efficiency of Computerized Insulin Infusion Glucose Control in Critically Ill Patients |
| title_full | Efficiency of Computerized Insulin Infusion Glucose Control in Critically Ill Patients |
| title_fullStr | Efficiency of Computerized Insulin Infusion Glucose Control in Critically Ill Patients |
| title_full_unstemmed | Efficiency of Computerized Insulin Infusion Glucose Control in Critically Ill Patients |
| title_short | Efficiency of Computerized Insulin Infusion Glucose Control in Critically Ill Patients |
| title_sort | efficiency of computerized insulin infusion glucose control in critically ill patients |
| topic | hyperglycemia hypoglycemia insulin intensive care units |
| url | http://www.jacs.or.kr/upload/pdf/jacs-2020-10-2-53.pdf |
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