Use of a Computer-Guided Glucose Management System to Improve Glycemic Control and Address National Quality Measures: A 7-Year, Retrospective Observational Study at A Tertiary Care Teaching Hospital

Tanenberg, Robert J.; Hardee, Sandra; Rothermel, Caitlin; Drake, Almond J.

doi:10.4158/ep161402.or

Cited by 21 publications

(9 citation statements)

References 35 publications

(37 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…4,9,11,13 The findings in this evaluation are consistent with those from previous comparisons of eGMS and PBPs in other clinical settings, primarily comparing cardiothoracic surgery patients. [19][20][21] In a recent study of bone marrow transplant patients, who like critically ill patients have substantially higher rates of morbidity and mortality, the feasibility of an eGMS was prospectively evaluated. In this cohort of 21 instances of hyperglycemia managed with eGMS, the rate of hypoglycemia defined as BG < 70 mg/dL was 0.9% and no patients experienced BG levels less than 40 mg/dL.…”

Section: Discussionmentioning

confidence: 99%

Risk of Hypoglycemia During Insulin Infusion Directed by Paper Protocol Versus Electronic Glycemic Management System in Critically Ill Patients at a Large Academic Medical Center

Rabinovich

Grahl

Durr

et al. 2017

J Diabetes Sci Technol

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Risk of Hypoglycemia During Insulin Infusion Directed by Paper Protocol Versus Electronic Glycemic Management System in Critically Ill Patients at a Large Academic Medical Center

Rabinovich

Grahl

Durr

et al. 2017

J Diabetes Sci Technol

View full text Add to dashboard Cite

show abstract

“…In addition, GV assessed using CV% was reported to be low at 26.5% (±12.9%), with only 4% of patients exhibiting glucose excursions (defined as BG levels >180 mg/dL once control was attained). 54…”

Section: Endotoolmentioning

confidence: 99%

Glucose Management Technologies for the Critically Ill

Salinas

Mendez

2019

J Diabetes Sci Technol

View full text Add to dashboard Cite

Hyperglycemia is common in the intensive care unit (ICU) both in patients with and without a previous diagnosis of diabetes. The optimal glucose range in the ICU population is still a matter of debate. Given the risk of hypoglycemia associated with intensive insulin therapy, current recommendations include treating hyperglycemia after two consecutive glucose >180 mg/dL with target levels of 140-180 mg/dL for most patients. The optimal method of sampling glucose and delivery of insulin in critically ill patients remains elusive. While point of care glucose meters are not consistently accurate and have to be used with caution, continuous glucose monitoring (CGM) is not standard of care, nor is it generally recommended for inpatient use. Intravenous insulin therapy using paper or electronic protocols remains the preferred approach for critically ill patients. The advent of new technologies, such as electronic glucose management, CGM, and closed-loop systems, promises to improve inpatient glycemic control in the critically ill with lower rates of hypoglycemia.

show abstract

“…The P, I, and D gains multiply these values using the most recent blood glucose measurements to calculate the insulin dose. PID control and similar dynamic scales in critical care include the Endotool (Monarch Medical, USA) [ 59 ], GRIP [ 60 ], Glucommander (Glytec Systems, USA) [ 61 ], GlucoCare (Pronia Medical, USA) [ 62 ], and GlucoStabiliser (Medical Decision Network, USA) [ 63 ] systems commercially and several research tools [ 13 , 14 , 64 – 66 ]. Advantages include simplicity and easy automation.…”

Section: Needs Statement and Goalsmentioning

confidence: 99%

Improving glycemic control in critically ill patients: personalized care to mimic the endocrine pancreas

et al. 2018

View full text Add to dashboard Cite

There is considerable physiological and clinical evidence of harm and increased risk of death associated with dysglycemia in critical care. However, glycemic control (GC) currently leads to increased hypoglycemia, independently associated with a greater risk of death. Indeed, recent evidence suggests GC is difficult to safely and effectively achieve for all patients. In this review, leading experts in the field discuss this evidence and relevant data in diabetology, including the artificial pancreas, and suggest how safe, effective GC can be achieved in critically ill patients in ways seeking to mimic normal islet cell function. The review is structured around the specific clinical hurdles of: understanding the patient’s metabolic state; designing GC to fit clinical practice, safety, efficacy, and workload; and the need for standardized metrics. These aspects are addressed by reviewing relevant recent advances in science and technology. Finally, we provide a set of concise recommendations to advance the safety, quality, consistency, and clinical uptake of GC in critical care. This review thus presents a roadmap toward better, more personalized metabolic care and improved patient outcomes.

show abstract

Use of a Computer-Guided Glucose Management System to Improve Glycemic Control and Address National Quality Measures: A 7-Year, Retrospective Observational Study at A Tertiary Care Teaching Hospital

Cited by 21 publications

References 35 publications

Risk of Hypoglycemia During Insulin Infusion Directed by Paper Protocol Versus Electronic Glycemic Management System in Critically Ill Patients at a Large Academic Medical Center

Risk of Hypoglycemia During Insulin Infusion Directed by Paper Protocol Versus Electronic Glycemic Management System in Critically Ill Patients at a Large Academic Medical Center

Glucose Management Technologies for the Critically Ill

Improving glycemic control in critically ill patients: personalized care to mimic the endocrine pancreas

Contact Info

Product

Resources

About