ArticleIntensive care medicine2007
Introduction and evaluation of a computerised insulin protocol.
Article in Intensive care medicine, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 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
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Tight glycemic control and computerized decision-support systems: a systematic review.Intensive care medicine · 2009Pooled it
- 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
- Tight computerized versus conventional glucose control in the ICU: a randomized controlled trial.Intensive care medicine · 2014Trial
- LOGIC-insulin algorithm-guided versus nurse-directed blood glucose control during critical illness: the LOGIC-1 single-center, randomized, controlled clinical trial.Diabetes care · 2013Trial
- Tight glycaemic control by an automated algorithm with time-variant sampling in medical ICU patients.Intensive care medicine · 2008Trial
- Strict versus moderate glucose control after resuscitation from ventricular fibrillation.Intensive care medicine · 2007Trial
- Hypoglycemia Prevention by Algorithm Design During Intravenous Insulin Infusion.Current diabetes reports · 2018Review
- Manual versus Automated moNitoring Accuracy of GlucosE II (MANAGE II).Critical care (London, England) · 2016Article
- The metrics of glycaemic control in critical care.Intensive care medicine · 2011Article
- Organ dysfunction is associated with hyperglycemia in critically ill children.Intensive care medicine · 2010Article
- International recommendations for glucose control in adult non diabetic critically ill patients.Critical care (London, England) · 2010Article
- Social, organizational, and contextual characteristics of clinical decision support systems for intensive insulin therapy: a literature review and case study.International journal of medical informatics · 2010Review
- Health technology assessment review: Computerized glucose regulation in the intensive care unit--how to create artificial control.Critical care (London, England) · 2009Review
- Assessing the performance of handheld glucose testing for critical care.Diabetes technology & therapeutics · 2008Article
- Evaluation of implementation of a fully automated algorithm (enhanced model predictive control) in an interacting infusion pump system for establishment of tight glycemic control in medical intensive care unit patients.Journal of diabetes science and technology · 2008Article
- Computer-assisted glucose control in critically ill patients.Intensive care medicine · 2008Article
- Evaluation of point-of-care glucose testing accuracy using locally-smoothed median absolute difference curves.Clinica chimica acta; international journal of clinical chemistry · 2008Article
- Year in review in Intensive Care Medicine, 2007. I. Experimental studies. Clinical studies: brain injury and neurology, renal failure and endocrinology.Intensive care medicine · 2008Review
- Glycemic penalty index for adequately assessing and comparing different blood glucose control algorithms.Critical care (London, England) · 2008Article
- Steps for the implementation and validation of tight glucose control.Intensive care medicine · 2007Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo 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.
designCohort study.
settingMixed adult ICU. PATIENTS AND
participantsAll 182 patients admitted to the ICU during a 3-month period were studied, except for 3 patients admitted for diabetic keto-acidosis.
interventionsFive 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
resultMean 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 </= 2.2 mmol/l) occurred, representing 0.5% of patients or 0.05% of glucose measurements.
conclusionsThe 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.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.