دورية أكاديمية
Introduction and evaluation of a computerised insulin protocol.
| العنوان: | Introduction and evaluation of a computerised insulin protocol. |
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| المؤلفون: | Meynaar IA; Intensive Care Unit, Reinier de Graaf Hospital, PO Box 5011, 2600 GA, Delft, Netherlands. meynaar@rdgg.nl, Dawson L, Tangkau PL, Salm EF, Rijks L |
| المصدر: | Intensive care medicine [Intensive Care Med] 2007 Apr; Vol. 33 (4), pp. 591-6. Date of Electronic Publication: 2006 Dec 20. |
| نوع المنشور: | Evaluation Study; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Verlag Country of Publication: United States NLM ID: 7704851 Publication Model: Print-Electronic Cited Medium: Print ISSN: 0342-4642 (Print) Linking ISSN: 03424642 NLM ISO Abbreviation: Intensive Care Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: New York : Springer Verlag Original Publication: Berlin ; New York, Springer International. |
| مواضيع طبية MeSH: | Blood Glucose*, Diabetes Mellitus/*drug therapy , Insulin/*therapeutic use, APACHE ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Algorithms ; Diabetes Mellitus/blood ; Diabetes Mellitus/nursing ; Female ; Hospital Mortality ; Humans ; Insulin/administration & dosage ; Intensive Care Units ; Male ; Middle Aged ; Monitoring, Physiologic ; Point-of-Care Systems |
| مستخلص: | Objective: To lower glucose levels in all patients in the intensive care unit (ICU) to the target range of 4.5-7.5 mmol/l using a nurse-driven computerised insulin protocol in combination with bedside glucose measurement. Design: Cohort study. Setting: Mixed adult ICU. Patients and Participants: All 182 patients admitted to the ICU during a 3-month period were studied, except for 3 patients admitted for diabetic keto-acidosis. Interventions: Five steps were taken to improve glucose regulation: (1) Nurses were authorised to adjust insulin dosage using a protocol. (2) Glucose was measured more often. (3) Glucose was measured at the bedside. (4) Consecutive protocols aimed for successively lower glucose levels; the final protocol had a target range of 4.5-7.5 mmol/l. (5) The protocol was computerised. MEASUREMENTS AND RESULT: Mean glucose decreased from 9.23 mmol/l without protocol to 7.68 mmol/l with the final protocol. This final protocol with the target of 4.5-7.5 mmol/l was evaluated more extensively. Glucose levels were measured a total of 1854 times in 179 ICU admissions during 552 ICU treatment days. The median glucose level was 7.0 mmol/l, and 53.1% of glucose measurements were within the target range of 4.5-7.5 mmol/l. One episode of hypoglycaemia (glucose Conclusions: The combined strategy of successively more ambitious nurse-driven (computerised) insulin protocols and bedside glucose measurement resulted in acceptably low glucose levels with very few episodes of hypoglycaemia. |
| التعليقات: | Comment in: Intensive Care Med. 2007 Apr;33(4):570-1. (PMID: 17177047) |
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| المشرفين على المادة: | 0 (Blood Glucose) 0 (Insulin) |
| تواريخ الأحداث: | Date Created: 20061221 Date Completed: 20070703 Latest Revision: 20191210 |
| رمز التحديث: | 20240829 |
| DOI: | 10.1007/s00134-006-0484-z |
| PMID: | 17177048 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 0342-4642 |
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| DOI: | 10.1007/s00134-006-0484-z |