Computer-assisted glucose control in critically ill patients

Objective Intensive insulin therapy is associated with the risk of hypoglycemia and increased costs of material and personnel. We therefore evaluated the safety and efficiency of a computer-assisted glucose control protocol in a large population of critically ill patients. Design and setting Observa...

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Bibliographic Details
Published in:Intensive care medicine 2008-08, Vol.34 (8), p.1421-1427
Main Authors: Vogelzang, Mathijs, Loef, Bert G., Regtien, Joost G., van der Horst, Iwan C. C., van Assen, Hein, Zijlstra, Felix, Nijsten, Maarten W. N.
Format: Article
Language:English
Subjects:
Aged
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Anesthesiology
Biological and medical sciences
Blood Glucose - drug effects
Computerized, statistical medical data processing and models in biomedicine
Computers
Critical Care - methods
Critical Care Medicine
Drug dosages
Drug Therapy, Computer-Assisted
Emergency Medicine
Evaluation Studies as Topic
Female
Glucose
Hospitals
Humans
Hypoglycemia
Hypoglycemia - chemically induced
Hypoglycemia - prevention & control
Hypoglycemic Agents - administration & dosage
Hypoglycemic Agents - adverse effects
Hypoglycemic Agents - therapeutic use
Infusion pumps
Insulin
Insulin - administration & dosage
Insulin - adverse effects
Insulin - therapeutic use
Insulin Infusion Systems
Intensive
Intensive care
Intensive care medicine
Intensive Care Units
Male
Medical computing and teaching
Medical sciences
Medicine
Medicine & Public Health
Middle Aged
Mortality
Multicenter Studies as Topic
Original
Pain Medicine
Patients
Pediatrics
Pneumology/Respiratory System
Teaching
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Summary:Objective Intensive insulin therapy is associated with the risk of hypoglycemia and increased costs of material and personnel. We therefore evaluated the safety and efficiency of a computer-assisted glucose control protocol in a large population of critically ill patients. Design and setting Observational cohort study in three intensive care units (32 beds) in a 1,300-bed university teaching hospital. Patients All 2,800 patients admitted to the surgical, neurosurgical, and cardiothoracic units; the study period started at each ICU after implementation of Glucose Regulation for Intensive Care Patients (GRIP), a freely available computer-assisted glucose control protocol. Measurements and results We analysed compliance in relation to recommended insulin pump rates and glucose measurement frequency. Patients were on GRIP-ordered pump rates 97% of time. Median measurement time was 5 min late (IQR 20 min early to 34 min late). Hypoglycemia was uncommon (7% of patients for mild hypoglycemia,
ISSN:0342-4642
1432-1238
DOI:10.1007/s00134-008-1091-y