Trial reportIntensive care medicine2010
Implementing glucose control in intensive care: a multicenter trial using statistical process control.
Trial report in Intensive care medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Glucose variability measures and their effect on mortality: a systematic review.Intensive care medicine · 2011Pooled it
- Estimating the Time to Benefit for Preventive Drugs with the Statistical Process Control Method: An Example with Alendronate.Drugs & aging · 2016Trial
- Usability study of a new tool for nutritional and glycemic management in adult intensive care: Glucosafe 2.Journal of clinical monitoring and computing · 2021Article
- Glucose variability during delirium in diabetic and non-diabetic intensive care unit patients: A prospective cohort study.PloS one · 2018Article
- Testing the implementation of an electronic process-of-care checklist for use during morning medical rounds in a tertiary intensive care unit: a prospective before-after study.Annals of intensive care · 2015Article
- Correlation between high blood IL-6 level, hyperglycemia, and glucose control in septic patients.Critical care (London, England) · 2012Article
- Risk factors for hypoglycaemia in neurocritical care patients.Intensive care medicine · 2012Article
- Implementing and evaluating a multicomponent inpatient diabetes management program: putting research into practice.Joint Commission journal on quality and patient safety · 2012Article
- Intensive insulin therapy in critically ill hospitalized patients: making it safe and effective.Journal of diabetes science and technology · 2011Review
- Year in review in Intensive Care Medicine 2010: I. Acute renal failure, outcome, risk assessment and ICU performance, sepsis, neuro intensive care and experimentals.Intensive care medicine · 2011Article
- Year in review 2009: Critical Care--metabolism.Critical care (London, England) · 2010Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGlucose control (GC) with insulin decreases morbidity and mortality of critically ill patients. In this study we investigated GC performance over time during implementation of GC strategies within three intensive care units (ICUs) and in routine clinical practice.
methodsAll adult critically ill patients who stayed for >24 h between 1999 and 2007 were included. Effects of implementing local GC guidelines and guideline revisions on effectiveness/efficiency-related indicators, safety-related indicators, and protocol-related indicators were measured.
resultsData of 17,111 patient admissions were evaluated, with 714,141 available blood glucose levels (BGL) measurements. Mean BGL, time to reach target, hyperglycemia index, sampling frequency, percentage of hyperglycemia events, and in-range measurements statistically changed after introducing GC in all ICUs. The introduction of simple rules on GC had the largest effect. Subsequent changes in the protocol had a smaller effect than the introduction of the protocol itself. As soon as the protocol was introduced, in all ICUs the percentage of hypoglycemia events increased. Various revisions were implemented to reduce hypoglycemia events, but levels never returned to those from pre-implementation. More intensive implementation strategies including the use of a decision support system resulted in better control of the process.
conclusionThere are various strategies to achieve GC in routine clinical practice but with variable success. All of them were associated with an increase in hypoglycemia events, but GC was never stopped. Instead, these events have been accepted and managed. Statistical process control is a useful tool for monitoring phenomena over time and captures within-institution changes.
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Registered trials
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