Improving blood sugar control during critical illness: a cohort study

Article


O'Connor, Enda, Tragen, David, Fahey, Paul P., 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. https://doi.org/10.1016/j.jcrc.2008.10.008
Article Title

Improving blood sugar control during critical illness: a cohort study

ERA Journal ID16351
Article CategoryArticle
AuthorsO'Connor, Enda (Author), Tragen, David (Author), Fahey, Paul P. (Author), Robinson, Michael (Author) and Cremasco, Theresa (Author)
Journal TitleJournal of Critical Care
Journal Citation25 (1), pp. 78-83
Number of Pages6
Year2010
Place of PublicationUSA
ISSN0883-9441
1557-8615
Digital Object Identifier (DOI)https://doi.org/10.1016/j.jcrc.2008.10.008
Abstract

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.

Keywordscritical illness; glucose; insulin; nursing care; hyperglycemia
ANZSRC Field of Research 2020429999. Other health sciences not elsewhere classified
320202. Clinical chemistry (incl. diagnostics)
320199. Cardiovascular medicine and haematology not elsewhere classified
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Byline AffiliationsUniversity of Queensland
Centre for Rural and Remote Area Health
Royal Hallamshire Hospital, United Kingdom
Department of Health, Queensland
Institution of OriginUniversity of Southern Queensland
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