Blood glucose control using an artificial pancreas reduces the workload of ICU nurses

Abstract

Blood glucose management is one of the important therapies in the intensive care unit (ICU). However, blood glucose management using the sliding-scale method increases the workload of ICU nurses. An artificial pancreas, STG-22, has been developed to continuously monitor blood glucose levels and to maintain them at appropriate levels. In this study, we examined the hypothesis that compared to conventional methods, blood glucose management using the STG-22 reduces the workload of ICU nurses and has a positive impact on awareness regarding the management of blood glucose. This study included 45 patients who underwent elective surgery and were treated at the ICU postoperatively. The patients were separated into the following two groups: (1) blood glucose was maintained using the STG-22 (AP group) and (2) blood glucose was maintained using the sliding-scale method (SS group). In addition, a questionnaire was developed for an awareness survey of ICU nurses (N = 20). The frequency of blood sampling and number of double checks were significantly lower in the AP group (1.3 ± 1.4 vs. 8.9 ± 8.1 times/admission, P < 0.001; 1.0 ± 1.4 vs. 9.8 ± 8.5 times/admission, P < 0.001). The time needed for glucose management per admission was significantly shorter in the AP group (9 ± 13 vs. 27 ± 24 min/admission; P = 0.003). Use of STG-22 for glucose management in the ICU increased the degree of attention given by nurses to glucose management and contributed to an improved sense of security. In conclusion, using the STG-22 in the ICU reduces the workload of ICU nurses compared to using the sliding-scale method. It also contributed to the reduction of the ICU nurses' anxiety related to the management of blood glucose.

How to Assess the Quality of Glucose Clamps? Evaluation of Clamps Performed With ClampArt, a Novel Automated Clamp Device

“…In addition, with automated clamps there is no room for bias caused by the clamper, 15 whereas there is a theoretical possibility that with manual clamps a clamper (instinctively) modifies the GIR in anticipation of a certain PD effect or follows certain patterns in GIR-modifications rather than reacting to the actually measured BG levels. Until now the Biostator (developed in the early 1970s by Life Sciences Instruments, Elkhart, IN) 16 and the STG-22 TM /STG-55 TM (a device developed by Nikkiso, Tokyo, Japan) [17][18][19] have been the only devices used for automated glucose clamps.…”

The Relation between Postoperative Blood Sugar Level and Infection

“…Böylece bir yandan kan şekeri düzeyine göre insülin infüzyonu otomatik olarak sağlanırken olası hipoglisemi geliştiğinde diğer bir pompa aracılığı ile hastaya glikoz veya glukagon da verilebilmektedir (28) . Kritik hastalarda ameliyat sırasında ve postoperatif devrede kısa süreli kullanımları nedeniyle hasta başı yapay pankreasın bu hastalarda yararlı olduğu ve özellikle yoğun bakım birimlerinde hemşirenin iş yoğun-luğunun azalmasında önemli bir role sahip oldukları vurgulanmaktadır (25) . Yukarıda değinilen veriler, postoperatif devrede, özellikle infeksiyöz komplikasyonların önlenebilmesi ve sepsise bağlı morbidite ve mortalitenin azaltılması için gerektiğinde yoğun insülin tedavisi ile hastalarda kan şekerinin 150 mg/dl altında tutulmasının önemli olduğunu vurgulamaktadır.…”

Automating Blood Glucose Control

“…Nurses dealing with the care of critically ill patients in the ICU are constantly under tension and stress [29]. Under these situations, a lot of stress is caused to ICU nurses because of the frequent measurements of blood glucose levels and the repetitive handling of insulin, which is likely to cause incidents [30]. Although computer-assisted insulin infusion protocols have been used increasingly in recent years, changes in insulin and monitoring of blood glucose levels remains an essential task.…”

“…Although computer-assisted insulin infusion protocols have been used increasingly in recent years, changes in insulin and monitoring of blood glucose levels remains an essential task. In this respect, the STG-22 is better able to reduce staff workloads than the conventional sliding-scale method of glucose control [30]. By using an artificial pancreas, the amount of labor spent per patient was reduced by about 20 min, and stress was substantially relieved.…”

“…By using an artificial pancreas, the amount of labor spent per patient was reduced by about 20 min, and stress was substantially relieved. Because this allows nurses to devote more time and concentration on other care-giving tasks, it may contribute to the improvement of the overall quality of care and to the reduction of the risk of occurrence of other incidents [30].…”