Observational Study on Saveng Protocol of Glucose Control in Intensive Care Unit

Abstract

Background: Hyperglycemia (>180 mg/dL or >10.0 mmol/L) has serious health implications in intensive care unit (ICU) patients. The aim of the present study was to explore the effectiveness of SavenG (Sanjith's Very Easy Nurse managed glucose control) protocol in the maintenance of glucose concentration in ICU patients. Materials and Methods: In this observational study, a total of 108 patients admitted to the ICU unit of SL Raheja hospital, a tertiary care institute in Mumbai, were enrolled. The patients received insulin therapy as proposed in SavenG protocol. The glucose in serum was measured using a glucometer and was categorized into three levels: <150 mg/dL, 150–200 mg/dL, and >200 mg/dL. The collected data were statistically analyzed by using SPSS version 24.0. Results: Patients were primarily male (69%), with an average age of 63.96 ± 13.14 years, reporting at least two complications (1.49 ± 1.03), and with a greater risk of hypertension (60%). Higher doses of insulin (~59.9 units) were administered on the first two days of protocol. By day 5, the requirement of insulin dose was gradually decreased to 36.8 units. The insulin was administered for totally seven days. The insulin dosing that was administered was sufficient to maintain the glucose level of 150–200 mg/dL for 12 h (F = 79.35, P < 0.01) and this sugar level showed a comparatively lower level of variation within a day (F = 13.123, P < 0.01). Further, the sugar level was not influenced by demographic characteristics such as age, gender and concomitant complications such as hypertension, ischemic heart disease, coronary artery bypass grafting, and kidney disease. Conclusion: The proposed SavenG protocol validates the effectiveness of insulin doses to regulate and maintain the glucose level at 150–200 mg/dL for 12 h within a day in ICU patients.