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首页> 外文期刊>The Canadian journal of hospital pharmacy. >Implementation of the Glucommander Method of Adjusting Insulin infusions in Critically III Patients
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Implementation of the Glucommander Method of Adjusting Insulin infusions in Critically III Patients

机译：Glucommander方法在重症III类患者中调整胰岛素输注的实施

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Background: Intensive giycemic control has been associated with reduced morbidity and mortality in critically ill patients. Web-based, patient-specific insulin nomograms may facilitate improved glucose control. Objective: To compare 2 algorithms for individualizing insulin infusion therapy (a web-based system [Glucommander method] and a standard paper-based nomogram) in a cardiovascular surgery intensive care unit (ICU). Methods: In this ptospective, befoie-after cohort study, measures of giycemic control for 50 patients receiving insulin according to the Glucommander system were compared with a control group (n = 50) who received insulin according to the standard paper-based nomogram used in the cardiovascular surgery ICU. Results: There was no significant difference between the 2 groups with respect to time to target blood glucose (5.1-8.0 mmol/L), percentage of time within the target range, or mean amplitude of glucose excursion. Patients in the intervention group spent less time above the target range (p = 0.007) and more time below the target range (p < 0.001), and the mean glucose was lower in this group compared with the control group (7.9 versus 8.6 mmol/L, p = 0.002). The percentage of blood glucose measurements below 4 mmol/L was higher in the intervention group than in the control group (3.7% versus 1.4%, p = 0.003). Satisfaction surveys revealed that the program was well accepted by the nursing staff in the cardiovascular surgery ICU. Conclusions: A web-based insulin nomogram was an easy-to-use instrument for achieving tighter glucose contiol for patients in the cardiovascular surgery ICU. Use of the Glucommander system led to lower mean blood glucose but an increase in episodes of hypoglycemia.
机译：背景：严格的降血糖药控制与危重患者的发病率和死亡率降低相关。基于网络的，患者特定的胰岛素诺模图可能有助于改善血糖控制。目的：比较两种在心血管外科重症监护病房（ICU）中进行个性化胰岛素输注治疗的算法（基于Web的系统[Glucommander方法]和基于纸张的诺模图标准）。方法：在这项前瞻性队列研究之后，将根据Glucommander系统对50例接受胰岛素治疗的患者的血糖控制指标与对照组（n = 50）进行了对比，根据对照组使用的标准纸质列线图进行胰岛素治疗。心血管外科ICU。结果：两组在目标血糖时间（5.1-8.0 mmol / L），目标范围内的时间百分比或平均葡萄糖偏移幅度方面无显着差异。干预组患者花费在目标范围之上的时间更少（p = 0.007），而在目标范围之下的时间则更长（p <0.001），并且该组的平均血糖低于对照组（7.9 vs 8.6 mmol / L，p ＝ 0.002）。干预组的血糖测量值低于4 mmol / L的百分比高于对照组（3.7％对1.4％，p = 0.003）。满意度调查显示，该程序已被心血管外科ICU的护理人员很好地接受。结论：基于网络的胰岛素诺模图是一种易于使用的工具，可为心血管外科ICU患者提供更严格的血糖控制。使用Glucommander系统可降低平均血糖，但增加低血糖发作。

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