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Improving blood sugar control during critical illness: a cohort study.
J Crit Care. 2010 Mar; 25(1):78-83.JC

Abstract

PURPOSE

The aim of this study is to compare blood sugar control and safety profile of nurse-titrated and medically ordered glucose-insulin regimens.

MATERIALS AND METHODS

We conducted a retrospective cohort study in a 9-bedded regional intensive care unit (ICU) in Queensland, Australia. Seventy critically ill patients requiring one-on-one nursing and intravenous insulin were included. In the nursing group, the ICU nurse decided initial and ongoing insulin infusion rates and glucose measurement frequency. The medical group had a traditional insulin sliding scale prescription.

RESULTS

Thirty-seven patients in the nursing group had 1949 glucose measurements. Thirty-three patients in the medical group had 2118 measurements. Mean blood sugar levels (+/-SD) were 8.33 +/- 2.34 and 8.78 +/- 2.74 in nursing and medical groups (P < .001). Eighteen percent of glucose readings were greater than 10 mmol/L in the nursing group compared with 27% in the medical group (P = .038). The incidence of hypoglycemia (<2.2 mmol/L) was similar in the 2 groups.

CONCLUSIONS

In a regional ICU, nurse-titrated glycemic control is safe, effective, and results in high compliance with a glucose target range.

Authors+Show Affiliations

University of Queensland, Toowoomba Health Service District, Toowoomba, Qld 4350, Australia. endamed@yahoo.com.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19327316

Citation

O'Connor, Enda, et al. "Improving Blood Sugar Control During Critical Illness: a Cohort Study." Journal of Critical Care, vol. 25, no. 1, 2010, pp. 78-83.
O'Connor E, Tragen D, Fahey P, et al. Improving blood sugar control during critical illness: a cohort study. J Crit Care. 2010;25(1):78-83.
O'Connor, E., Tragen, D., Fahey, P., Robinson, M., & Cremasco, T. (2010). Improving blood sugar control during critical illness: a cohort study. Journal of Critical Care, 25(1), 78-83. https://doi.org/10.1016/j.jcrc.2008.10.008
O'Connor E, et al. Improving Blood Sugar Control During Critical Illness: a Cohort Study. J Crit Care. 2010;25(1):78-83. PubMed PMID: 19327316.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Improving blood sugar control during critical illness: a cohort study. AU - O'Connor,Enda, AU - Tragen,David, AU - Fahey,Paul, AU - Robinson,Michael, AU - Cremasco,Theresa, Y1 - 2009/02/13/ PY - 2008/07/04/received PY - 2008/10/02/revised PY - 2008/10/12/accepted PY - 2009/3/31/entrez PY - 2009/3/31/pubmed PY - 2010/4/21/medline SP - 78 EP - 83 JF - Journal of critical care JO - J Crit Care VL - 25 IS - 1 N2 - PURPOSE: The aim of this study is to compare blood sugar control and safety profile of nurse-titrated and medically ordered glucose-insulin regimens. MATERIALS AND METHODS: We conducted a retrospective cohort study in a 9-bedded regional intensive care unit (ICU) in Queensland, Australia. Seventy critically ill patients requiring one-on-one nursing and intravenous insulin were included. In the nursing group, the ICU nurse decided initial and ongoing insulin infusion rates and glucose measurement frequency. The medical group had a traditional insulin sliding scale prescription. RESULTS: Thirty-seven patients in the nursing group had 1949 glucose measurements. Thirty-three patients in the medical group had 2118 measurements. Mean blood sugar levels (+/-SD) were 8.33 +/- 2.34 and 8.78 +/- 2.74 in nursing and medical groups (P < .001). Eighteen percent of glucose readings were greater than 10 mmol/L in the nursing group compared with 27% in the medical group (P = .038). The incidence of hypoglycemia (<2.2 mmol/L) was similar in the 2 groups. CONCLUSIONS: In a regional ICU, nurse-titrated glycemic control is safe, effective, and results in high compliance with a glucose target range. SN - 1557-8615 UR - https://www.unboundmedicine.com/medline/citation/19327316/Improving_blood_sugar_control_during_critical_illness:_a_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0883-9441(08)00207-4 DB - PRIME DP - Unbound Medicine ER -