Continuous Intravenous Insulin: An Evaluation in Bariatric Patients Outside of the Intensive Care Unit

2012 ◽  
Vol 7 (4) ◽  
pp. 172-182
Author(s):  
Melanie E. Mabrey ◽  
Allison Vorderstrasse ◽  
Mary Champagne ◽  
Lisa Clark Pickett
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intravenous Insulin ◽  
Bariatric Patients

GLYCEMIA CONTROL WITH AN INTENSIVE INTRAVENOUS INSULIN PROTOCOL IN PATIENTS ADMITTED TO THE INTENSIVE CARE UNIT.

2005 ◽  
Vol 33 ◽  
pp. A75
Author(s):  
andre bonnici ◽  
Robert Salasidis ◽  
Judith Marin ◽  
Patrick Bouchard ◽  
Marcin Zakrzewski ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intravenous Insulin

scholarly journals EATING AND GLYCEMIC CONTROL AMONG CRITICALLY ILL PATIENTS RECEIVING CONTINUOUS INTRAVENOUS INSULIN

2020 ◽  
Vol 26 (1) ◽  
pp. 43-50
Author(s):  
Eli E. Miller ◽  
Mumtu Lalla ◽  
Alyssa Zaidi ◽  
May Elgash ◽  
Huaqing Zhao ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Coefficient Of Variation ◽  
Apache Ii Score ◽  
Weighted Mean ◽  
Icu Patients ◽  
Intravenous Insulin ◽  
Significant Difference

Objective: Consensus guidelines recommend that intensive care unit (ICU) patients with blood glucose (BG) levels >180 mg/dL receive continuous intravenous insulin (CII). The effectiveness of CII at controlling BG levels among patients who are eating relative to those who are eating nothing by mouth (nil per os; NPO) has not been described. Methods: We conducted a retrospective cohort study of 260 adult patients (156 eating, 104 NPO) admitted to an ICU between January 1, 2014, and December 31, 2014, who received CII. Patients were excluded for a diagnosis of diabetic ketoacidosis or hyperglycemic hyperosmolar nonketotic syndrome, admission to an obstetrics service, or receiving continuous enteral or parenteral nutrition. Results: Among 22 baseline characteristics, the proportion of patients receiving glucocorticoid treatment (GCTx) (17.3% eating, 37.5% NPO; P<.001) and APACHE II score (15.0 ± 7.5 eating, 17.9 ± 7.9 NPO; P = .004) were significantly different between eating and NPO patients. There was no significant difference in the primary outcome of patient-day weighted mean BG overall (153 ± 8 mg/dL eating, 156 ± 7 mg/dL NPO; P = .73), or day-by-day BG ( P = .37) adjusted for GCTx and APACHE score. Surprisingly, there was a significant difference in the distribution of BG values, with eating patients having a higher percentage of BG readings in the recommended range of 140 to 180 mg/dL. However, eating patients showed greater glucose variability (coefficient of variation 23.1 ± 1.0 eating, 21.2 ± 1.0 NPO; P = .034). Conclusion: Eating may not adversely affect BG levels of ICU patients receiving CII. Whether or not prandial insulin improves glycemic control in this setting should be studied. Abbreviations: BG = blood glucose; CII = continuous insulin infusion; CV = coefficient of variation; HbA1c = hemoglobin A1c; ICU = intensive care unit; NPO = nil per os; PDWMBG = patient day weighted mean blood glucose

scholarly journals The association of intravenous insulin and glucose infusion with intensive care unit and hospital mortality: a retrospective study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Sigrid C. van Steen ◽  
Saskia Rijkenberg ◽  
Peter H. J. van der Voort ◽  
J. Hans DeVries
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Retrospective Study ◽  
Hospital Mortality ◽  
Glucose Infusion ◽  
Intravenous Insulin

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

Nurse-Led Implementation of a Safe and Effective Intravenous Insulin Protocol in a Medical Intensive Care Unit

2011 ◽  
Vol 31 (6) ◽  
pp. 27-35 ◽  
Author(s):  
Rabia Khalaila ◽  
Eugene Libersky ◽  
Dina Catz ◽  
Elina Pomerantsev ◽  
Abed Bayya ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Glucose ◽  
Medical Intensive Care Unit ◽  
Control Group ◽  
Glucose Levels ◽  
Intravenous Insulin ◽  
Blood Glucose Levels ◽  
Protocol Group ◽  
Medical Intensive Care

BackgroundRecent evidence has linked tight glucose control to worsened clinical outcomes among adults in intensive care units.ObjectiveTo evaluate the effectiveness and safety of a nurse-led intravenous insulin protocol designed to achieve conservative blood glucose control in patients in a medical intensive care unit.MethodsA nurse-led intravenous insulin protocol was developed, targeting blood glucose levels at 110 to 149 mg/dL. Hypoglycemia was defined as a blood glucose level less than 70 mg/dL. Patients admitted to the medical intensive care unit who required an insulin infusion were enrolled in the study. Blood glucose levels in those patients were compared with levels in 153 historical control patients admitted to the unit in the 12 months before the protocol was implemented who required an insulin infusion.ResultsNinety-six patients were enrolled and treated with the protocol. The protocol and control groups had similar characteristics at baseline. More measurements in the protocol group than in the control group (46.3% vs 36.1%, P&lt;.001) were within the target glucose range (110–149 mg/dL). Hyperglycemia (blood glucose ≥200 mg/dL) occurred less often in the protocol group than in the control group (14.8% vs 20.1%, P=.003). Hypoglycemic events (blood glucose &lt;70 mg/dL) also occurred less often in the protocol group (0.07% vs 0.83%, P&lt;.001).ConclusionsImplementation of a nurse-led, conservative intravenous insulin protocol in the medical intensive care unit is effective and safe and markedly reduces the rate of hypoglycemia.

Utilization of a Computerized Intravenous Insulin Infusion Program to Control Blood Glucose in the Intensive Care Unit

2007 ◽  
Vol 9 (3) ◽  
pp. 232-240 ◽  
Author(s):  
Rattan Juneja ◽  
Corbin Roudebush ◽  
Nilay Kumar ◽  
Angela Macy ◽  
Adam Golas ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Glucose ◽  
Insulin Infusion ◽  
Control Blood Glucose ◽  
Intravenous Insulin

scholarly journals Glycaemic control in critical care: Can flash glucose monitoring help?

2021 ◽  
pp. 175114372110433
Author(s):  
Jessica Moncrieff ◽  
Vijay Jayagopal ◽  
David Yates
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Glycaemic Control ◽  
Glucose Monitoring ◽  
Flash Glucose Monitoring ◽  
Intravenous Insulin ◽  
Good Glycaemic Control ◽  
Freestyle Libre ◽  
The Impact

Good glycaemic control confers an outcome benefit in both diabetic and non-diabetic critically unwell patients. Critically unwell patients receiving intravenous insulin in the intensive care unit (ICU) require hourly glucose monitoring. This brief communication highlights the impact of the introduction of the FreeStyle Libre glucose monitor, a form of continuous glucose monitoring, on the frequency of glucose recordings in patients receiving intravenous insulin in the ICU at York Teaching Hospital NHS Foundation Trust.

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