Glucose Control in the Critically Ill Patient Utilizing Computerized Intravenous Insulin Dosing

Crockett, Samuel E.

doi:10.17925/use.2009.05.1.45

Cited by 3 publications

(3 citation statements)

References 36 publications

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“…As controversial as it has been, there is a much evidence in support of, as there is against tight glycemic control. The critical issue, therefore, is the ability to find adequate balance on the gradient of glycemia, so that severe hypoglycemia is not experienced, which would subsequently increase the risk of mortality (Crockett, 2009; Moghissi et al, 2009; Reider, Donihl, & Korytkowski, 2009).…”

Section: Impact Of Hyperglycemia On Patient Outcomesmentioning

confidence: 99%

Changes in the treatment of inpatient hyperglycemia: What every nurse practitioner should know about the 2012 Standards of Care

Talley

Hill

Steadman

et al. 2012

Journal of the American Academy of Nurse Practitioners

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Purpose: To provide nurse practitioners (NPs) with a review of the 2012 Standards of Care for the management of hospitalized patients who are hyperglycemic. Data sources: The 2012 American Diabetes Association's (ADA) Standards of Care for the treatment of inpatient hyperglycemia and selected evidence-based articles. Conclusions: Because hyperglycemia occurs at alarming rates in the inpatient setting when hyperglycemia is not controlled, there is a great impact on acute and even chronic conditions. These complications will lead to increased healthcare costs. Implications for practice: It is essential that NPs who care for hospitalized, hyperglycemic patients are aware of the 2012 ADA Standards of Care.Diabetes mellitus is one of the most costly chronic diseases nationwide with inpatient care cost approaching $40 billion per year (Patel & Doughty, 2008). Recently, medical science witnessed new treatments and protocols for a wide spectrum of illnesses. However, little has changed with regard to the urgency for the improvement in inpatient needs for euglycemia from 2011 to 2012. Hyperglycemia remains a very distinct problem in the inpatient population (Moghissi et al., 2009). Hence, the Diabetes Care journal includes recommendations each year on the management of this special population of patients. The recommendations are based on the American Diabetes Association (ADA) and American Association of Clinical Endocrinologists (AACE) consensus statement on glycemic control. These organizations find it necessary to establish, publish, and revisit recommendations for inpatient hyperglycemic treatment on an annual basis. The purpose of this article is to update nurse practitioners (NPs) on the changes in the 2012 Standards of Care for management of hyperglycemia in hospitalized patients.

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Section: Impact Of Hyperglycemia On Patient Outcomesmentioning

confidence: 99%

Changes in the treatment of inpatient hyperglycemia: What every nurse practitioner should know about the 2012 Standards of Care

Talley

Hill

Steadman

et al. 2012

Journal of the American Academy of Nurse Practitioners

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“…2,6 -11 There is increasing evidence that a computerized insulin dosing tool (CIDT) reduces the number of hypoglycemic events, time to target blood glucose (BG), and variation in BG over time when treating hyperglycemia in critically ill patients. 12 -15 Although promising results have been seen, application of a CIDT in addition to a DKA order set for the treatment of DKA has not been evaluated. Our objective was to determine the potential benefits and risks a CIDT would have on the treatment of patients with DKA.…”

mentioning

confidence: 99%

Evaluation of a Computerized Insulin Dosing Tool for the Treatment of Diabetic Ketoacidosis

Defayette

Voigt

Zammit

et al. 2019

Journal of Pharmacy Practice

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Purpose: Computerized insulin dosing tools (CIDT) have been shown to improve the care of critically ill patients with hyperglycemia. Application of a CIDT in addition to a diabetic ketoacidosis (DKA) order set for the treatment of DKA has not been evaluated. Our goal was to determine the effects the CIDT would have on the treatment of a patient with DKA. Methods: In this retrospective, pre–post chart review, a provider-driven insulin dosing strategy (pregroup) was compared to the CIDT (postgroup) with 24-hour pharmacist monitoring. The CIDT utilized an equation that incorporated a patient’s most recent blood glucose (BG) value and recommended a rate of insulin (units/hour) every hour. Results: All baseline characterizes were similar between the 2 groups. There were no significant differences in average time to anion gap closure (≤ 12 mEq/L) or intensive care unit length of stay between the pregroup and postgroup (12.5 [6] hours vs 10.5 [7] hours, P = 0.235; 40.6 [24] hours vs 40.8 [24] hours, P = 0.945). Although not statistically significant, 17 hypoglycemic events (BG < 70 mg/dL) occurred in the pregroup with 4 being severe (BG < 50 mg/dL) while 5 hypoglycemic events occurred in the postgroup, none of which were severe. Conclusion: This study suggests, when compared to a provider-driven insulin dosing strategy, the CIDT with 24-hour pharmacist monitoring is efficacious and safe for treatment of patients with a primary diagnosis of DKA.

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“…As an alternative to such paper protocols, computer-guided glucose management systems are now starting to be used to improve glucose management by reducing insulin infusion calculation errors and standardizing therapy (7). EndoTool is one such system.…”

mentioning

confidence: 99%

Evaluating the Implementation of the EndoTool Glycemic Control Software System

2018

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Glucose Control in the Critically Ill Patient Utilizing Computerized Intravenous Insulin Dosing

Cited by 3 publications

References 36 publications

Changes in the treatment of inpatient hyperglycemia: What every nurse practitioner should know about the 2012 Standards of Care

Changes in the treatment of inpatient hyperglycemia: What every nurse practitioner should know about the 2012 Standards of Care

Evaluation of a Computerized Insulin Dosing Tool for the Treatment of Diabetic Ketoacidosis

Evaluating the Implementation of the EndoTool Glycemic Control Software System

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