Glucommander - A computer-directed intravenous insulin system shown to be safe, simple, and effective in 120,618 h of operation
Glucommander - A computer-directed intravenous insulin system shown to be safe, simple, and effective in 120,618 h of operation
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DOI：
10.2337/diacare.28.10.2418
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发表时间：
2005-10-01
期刊：
影响因子：
16.2
通讯作者：
Bode, BW
中科院分区：
文献类型：
--
作者：
Davidson, PC;Steed, RD;Bode, BW
目的-静脉注射胰岛素是目前医院中危重患者糖尿病管理的推荐方法。已公布的方法管理的胰岛素是复杂的，通常限于重症监护病房与低patient-to-nurse ratio.RESEARCH设计和方法-一种计算机指导的算法，建议静脉注射胰岛素，是灵活的血糖时间，并建议胰岛素剂量在一个渐进的方式已经开发。这个软件程序，被称为Glucommander，已经被我们的团队广泛使用。数据进行了分析，本study.RESULTS -从5,080静脉注射胰岛素运行超过120,683小时的数据表明，血糖水平可以安全地稳定在一个目标范围内，没有显着的低血糖症的非专业护士工作在任何单位的综合医院。平均血糖水平在3 h内达到< 150 mg/dl。所有葡萄糖值中只有0.6%< 50 mg/dl。低血糖< 40 mg/dl的患病率为所有运行的2.6%。结论-这种计算机指导的算法是一种简单，安全，有效，和强大的方法来维持血糖控制。它已被广泛研究，并适用于各种各样的条件。与其他已发表的仅限于重症监护病房的静脉注射胰岛素方案相比，Glucommander可用于任何医院的所有单位。
OBJECTIVE - intravenous insulin is now the recommended method of diabetes management in critically ill persons in the hospital. The published methods for administering the insulin are complex and are usually limited to intensive care units with a low patient-to-nurse ratio.RESEARCH DESIGN AND METHODS - A computer-directed algorithm for advice on the delivery of intravenous insulin that is flexible in blood glucose timing and advises insulin dosing in a graduated manner has been developed. This software program, known as the Glucommander, has been used extensively by our group. The data were analyzed for this study.RESULTS - The data from 5,080 intravenous insulin runs over 120,683 h show that blood glucose levels can be safely stabilized in a target range without significant hypoglycemia by nonspecialized nurses working on any unit of a general hospital. The mean glucose level reached < 150 mg/dl in 3 h. Only 0.6% of all glucose values were < 50 mg/dl. The prevalence of hypoglycemia < 40 mg/dl was 2.6% of all runs. No hypoglycemia was severe.CONCLUSIONS - This computer-directed algorithm is a simple, safe, effective, and robust method for maintaining glycemic control. It has been extensively studied and is applicable in a wide variety of conditions. In contrast to other published intravenous insulin protocols, which have been limited to intensive care units, Glucommander can be used in all units of any hospital.