Efficiency and Safety of a Standardized Protocol for Intravenous Insulin Therapy in ICU Patients with Neurovascular or Head Injury
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To evaluate the safety and efficiency of a protocol for glycemic control in intensive care unit (ICU) patients with neurovascular or head injury.
Two cohorts of 50 consecutive patients admitted to the ICU with an admission diagnosis of neurovascular or head injury before and after protocol implementation were evaluated. All patients in the interventional cohort received insulin using a standardized intravenous insulin infusion protocol targeting blood glucose levels of 7–9 mmol/l. Efficiency (time to reach and time within target range), safety (hypoglycemia), and nursing compliance (protocol violations) were evaluated.
The median time to reach the target blood glucose range was shorter in the interventional cohort than the conventional cohort (5.0 h [0.5–20.5 h] vs. 12.9 h [1.3–90.3 h]; P < 0.001). More time was spent within target range in the interventional cohort than in the conventional cohort (36.4 ± 16.3% vs. 27.1 ± 19.0%; P < 0.001). The median prevalence of mild (<4.9 mmol/l) hypoglycemia (0 [0–1.11]% vs. 0.58 [0–2.79]%; P < 0.001) and moderate (<3.9) hypoglycemia (0[0–0.55]% vs. 0 [1–1.25]%; p < 0.001) was significantly lower in the interventional cohort.
The intravenous insulin infusion protocol improved the safety and efficiency of glycemic control for ICU patients with neurovascular or head injury.
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- Efficiency and Safety of a Standardized Protocol for Intravenous Insulin Therapy in ICU Patients with Neurovascular or Head Injury
Volume 12, Issue 1 , pp 43-49
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- Intensive care units
- Nervous system diseases
- Blood glucose
- Neurovascular injury
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- Author Affiliations
- 1. Department of Pharmacy, The Ottawa Hospital, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada
- 2. Department of Critical Care, The Ottawa Hospital, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada
- 3. Department of Clinical Epidemiology, The Ottawa Health Research Institute, Ottawa, Canada
- 4. Departments of Endocrinology and Metabolism, and Critical Care, The Ottawa Hospital, Ottawa, Canada
- 5. Departments of Critical Care and Anesthesiology, The Ottawa Hospital, Ottawa, Canada