Utilization of a computerized intravenous insulin infusion program to control blood glucose in the intensive care unit
Utilization of a computerized intravenous insulin infusion program to control blood glucose in the intensive care unit
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DOI：
10.1089/dia.2006.0015
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发表时间：
2007-06-01
影响因子：
5.4
通讯作者：
Flanders, Samuel J.
中科院分区：
文献类型：
--
作者：
Juneja, Rattan;Roudebush, Corbin;Flanders, Samuel J.
背景资料：这项概念验证研究旨在评估静脉注射胰岛素剂量计算器Clarian GlucoStabilizer（TM）程序的安全性和有效性，并确定其作为血糖控制程序一部分的可行性。本文讨论了影响的GlucoStabilizer程序对重症监护患者的血糖控制高血糖症。方法：患者入住重症监护病房（ICU），需要静脉注射胰岛素，使用GlucoStabilizer程序进行治疗。该程序根据所需目标范围内的低血糖和高血糖（BG）水平、患者当前和先前的BG水平以及胰岛素敏感性因子计算胰岛素滴注速率，目标是安全、快速地达到并维持患者的BG在目标范围内。从2004年10月至2006年3月，GlucoStabilizer项目已用于治疗ICU中的2，398名患者，其数据库中有177，279个BG测量值。在这些患者中，61.0%的BG在80 - 110 mg/dL的目标范围内，而90.9%在60 - 150 mg/dL的更宽范围内。平均BG为106.5 mg/dL（SD 39.1 mg/dL），低血糖（BG <50 mg/dL）的频率为0.4%。这些结果比较有利的血糖控制水平，在3个月前实施的GlucoStabilizer program.Conclusions：使用的GlucoStabilizer程序在ICU导致改善血糖控制相比，以前手动计算血糖控制协议。
Background: This proof of concept study was designed to evaluate the safety and effectiveness of an intravenous insulin dosing calculator, the Clarian GlucoStabilizer (TM) program, and to determine the feasibility of its use as part of a glycemic control program. This paper discusses the impact of the GlucoStabilizer program on the glycemic control of intensive care patients with hyperglycemia.Methods: Patients admitted to the intensive care unit (ICU), requiring intravenous insulin, were treated using the GlucoStabilizer program. This program calculates an insulin drip rate based on the low and high blood glucose (BG) levels of the desired target range, the patient's current and previous BG levels, and an insulin sensitivity factor, with a goal of safely and expeditiously achieving and maintaining the patient's BG in the target range.Results: From October 2004 through March 2006, the GlucoStabilizer program has been used to treat 2,398 patients in the ICUs, with 177,279 BG measurements in its database. In these patients, 61.0% of BGs have been in the target range of 80-110 mg/dL, while 90.9% have been in the wider range of 60-150 mg/dL. The average BG was 106.5 mg/dL (SD 39.1 mg/dL), and the frequency of hypoglycemia (BG < 50 mg/dL) was 0.4%. These results compare favorably with the level of glycemic control in the 3 months before implementation of the GlucoStabilizer program.Conclusions: Use of the GlucoStabilizer program in the ICU resulted in improved glycemic control compared to the previous manually calculated glycemic control protocols.