ArticleCritical care medicine2001
Intravenous insulin nomogram improves blood glucose control in the critically ill.
Article in Critical care medicine, 2001. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2022Guideline
- A systematic review on quality indicators for tight glycaemic control in critically ill patients: need for an unambiguous indicator reference subset.Critical care (London, England) · 2008Pooled it
- Intensive insulin treatment improves forearm blood flow in critically ill patients: a randomized parallel design clinical trial.Critical care (London, England) · 2009Trial
- Assessing glycemic variability in critically ill patients: A prospective cohort study comparing insulin infusion therapy with insulin sliding scale.Scientific reports · 2024Observational
- Effect of Problem-Oriented Evidence-Based Nursing on Clinical Recovery and Prognosis in Patients with Arrhythmia after Acute Myocardial Infarction.Iranian journal of public health · 2022Article
- Reference Ranges of Glycemic Variability in Infants after Surgery-A Prospective Cohort Study.Nutrients · 2022Article
- Development and Validation of a Nomogram Incorporating Colloid Osmotic Pressure for Predicting Mortality in Critically Ill Neurological Patients.Frontiers in medicine · 2021Article
- Glycemic control in critically ill patients.World journal of critical care medicine · 2012Review
- Management of hyperglycemia during the perioperative period.Current diabetes reports · 2012Review
- Protocol-directed insulin infusion sliding scales improve perioperative hyperglycaemia in critical care.Perioperative medicine (London, England) · 2012Review
- Management of hyperglycemia in hospitalized patients.Annals of the New York Academy of Sciences · 2010Review
- Glycemic control in the medical intensive care unit.Journal of diabetes science and technology · 2009Review
- Glycemic penalty index for adequately assessing and comparing different blood glucose control algorithms.Critical care (London, England) · 2008Article
- Introduction and evaluation of a computerised insulin protocol.Intensive care medicine · 2007Article
- Design and implementation of GRIP: a computerized glucose control system at a surgical intensive care unit.BMC medical informatics and decision making · 2005Article
- Clinical review: Emergency department overcrowding and the potential impact on the critically ill.Critical care (London, England) · 2005Review
- Hyperglycaemic index as a tool to assess glucose control: a retrospective study.Critical care (London, England) · 2004Article
- Glycemic control in the ICU: a multicenter survey.Intensive care medicine · 2004Article
- Computer-based insulin infusion protocol improves glycemia control over manual protocol.Journal of the American Medical Informatics Association : JAMIAArticle
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo improve control of blood glucose concentrations in critically ill patients through use of a bedside, nurse-managed, intravenous insulin nomogram.
designRetrospective, before-after cohort study.
settingFifteen-bed mixed medical/surgical intensive care unit in a tertiary, teaching hospital. PATIENTS: A total of 167 intensive care unit patients requiring intravenous insulin infusions during two 9-month periods.
interventionThe sliding scale group was treated using ad hoc sliding scale infusion therapy. The intervention group was treated using a dosing nomogram that allowed the nurse to adjust the insulin infusion rate based on current glucose concentration and concurrent insulin infusion rates. The adjustments were made independent of physician input. MEASUREMENTS AND MAIN
resultsTime from initiating the insulin infusion to initial control of glucose concentration (<11.5 mmol/L) was determined. Effectiveness of glucose control was determined retrospectively by measuring the area under the curve of blood concentrations >11.5 mmol/L versus time of insulin infusion, divided by total duration of insulin infusion. The median time to initial control of glucose (<11.5 mmol/L) was 4 hr (range 1-38 hr) for the baseline and 2 hr (range 1-22 hr) for nomogram group (p =.0004). The median area under the curve of glucose concentration divided by duration of insulin infusion was 0.9 (range 0.0-5.9) for sliding scale group and 0.3 (range 0.0-11.1) for nomogram (p =.0001), without any increase in the frequency of episodes of hypoglycemia.
conclusionUse of an insulin nomogram in critically ill patients improves control of blood glucose concentrations and is safe.
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Registered trials
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