التفاصيل البيبلوغرافية
| العنوان: |
Insulin Requirement and Occurrence of Hypoglycemia in Patients Undergoing Renal Replacement Therapy (RRT) While on an Intensive Intravenous Insulin Protocol (IIIP). |
| المؤلفون: |
Bharaktiya, Shikha, Nelson, Sarah C., Burns, Allassia, Davis, Anu B., Boccalandro, Cristina, Lavis, Victor R. |
| المصدر: |
Diabetes; Jun2007 Supplement 1, Vol. 56, pA584-A584, 1/4p |
| مصطلحات موضوعية: |
INSULIN, HYPOGLYCEMIA, KIDNEY transplantation, INSULIN pumps, HEMODIALYSIS |
| مستخلص: |
In August 2006 we instituted a standardized HIP in the cardiovascular intensive care unit of our institution. The IIIP was modified from a published protocol based on the formula [(Current BG-60) X Sensitivity Factor] to determine the insulin infusion rate. The glycemic target was 80-110 mg/dL in the immediate postoperative period after cardiovascular surgery. We hypothesized that there would be a difference in the insulin requirements in patients on RRT and that there may be increased risk of hypoglycemia in that group. Hence we retrospectively examined the occurrence of hypoglycemic episodes (blood glucose <60mg/dl) and the differences in insulin requirements among 28 infusions, on patients who received standard or continuous venous-venous hemodialysis (RRT) versus 60 infusions on those who did not (NRRT). Seven infusions in the RRT group were on patients with established end stage kidney disease. In the RRT group, mean duration of insulin drip (ID) was 70 hrs (95% CI 40.6-99.9) versus 44 hours (95% CI 32.8-55.5) for NRRT. The median duration of ID was 46.5 hrs for RRT and 28 hrs for NRRT, which was statistically significant (p=0.047 by Mann-Whitney U test; α=0.05). There was no difference in the average hourly insulin requirement between the two groups (3.3 units/hr in RRT vs. 3.4 units/hr in NRRT). The number of hypoglycemic episodes was 28 in the RRT and 29 in the NRRT group. The total number of hypoglycemic episodes per drip-hour was 1.42% (RRT) and 1.09% (NRRT). The percentage of capillary glucose readings <60 mg/dL per fingerstick was 1.62% for RRT and 1.25% for NRRT. While the number of hours on the ID was greater for RRT, there was no significant difference in the average insulin requirement or the risk of hypoglycemia per drip-hour of intravenous insulin infusion. Thus this protocol did not cause an undue risk of hypoglycemia in patients receiving RRT. The reasons for the increased time on the ID in RRT are probably multifactorial, which along with outcome data will need to be studied prospectively. [ABSTRACT FROM AUTHOR] |
|
Copyright of Diabetes is the property of American Diabetes Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
Full Text Finder