Intensive insulin therapy for acute hyperglycemia.
There is growing evidence that control of hyperglycemia in the critically ill patient improves outcome. Normalizing blood glucose levels decreases the risk of developing sepsis, end-organ damage, and hospital mortality. Critical care clinicians must be familiar with current and benchmark research supporting control of hyperglycemia and use this knowledge to ensure appropriate application of evidence-based practice for decreasing or preventing complications in the critically ill patient. This article describes the effects of hyperglycemia and discusses the evidence supporting tight glycemic control in such patients. The necessary steps to implement an intensive insulin therapy protocol for control of acute hyperglycemia are detailed.
Read
Julia Lindeman
JL
Risk and Patient Safety, Kaiser Permanente, Fremont Medical Center, 39400 Paseo Padre Pkwy, Freemont, CA 94538, USA. Julie.Read@kp.org
Cheng
Eugene Y
EY
D000208:Acute Disease; D019985:Benchmarking / Q000458:organization & administration; D015984:Causality; D002985:Clinical Protocols; D017281:Cost of Illness; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness; D016903:Drug Monitoring; D019317:Evidence-Based Medicine; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008499:Medical Records; D010043:Outcome and Process Assessment, Health Care; D010564:Personnel, Hospital / Q000193:education; D016730:Program Development; D015397:Program Evaluation
D007004:Hypoglycemic Agents; D007328:Insulin