Improving blood sugar control during critical illness: a cohort study

O'Connor, Enda and Tragen, David and Fahey, Paul P. and Robinson, Michael and Cremasco, Theresa (2010) Improving blood sugar control during critical illness: a cohort study. Journal of Critical Care, 25 (1). pp. 78-83. ISSN 0883-9441


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 b .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 (b2.2 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.

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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Author version not held.
Faculty / Department / School: Historic - Faculty of Sciences - No Department
Date Deposited: 09 Mar 2011 04:40
Last Modified: 03 Jul 2013 00:32
Uncontrolled Keywords: critical illness; glucose; insulin; nursing care; hyperglycemia
Fields of Research : 11 Medical and Health Sciences > 1199 Other Medical and Health Sciences > 119999 Medical and Health Sciences not elsewhere classified
11 Medical and Health Sciences > 1103 Clinical Sciences > 110302 Clinical Chemistry (diagnostics)
11 Medical and Health Sciences > 1102 Cardiovascular Medicine and Haematology > 110299 Cardiovascular Medicine and Haematology not elsewhere classified
Socio-Economic Objective: C Society > 92 Health > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920199 Clinical Health (Organs, Diseases and Abnormal Conditions) not elsewhere classified
Identification Number or DOI: 10.1016/j.jcrc.2008.10.008

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