title: Influence of smart real-time electronic alerting on glucose control in critically ill patients.
abstract: OBJECTIVE
  Hyperglycemia and hypoglycemia are frequently encountered in critically ill patients and associated with adverse outcomes. We configured a smart glycemia alert (S-GLY alert) with our Intensive Care Information System to decrease the number of hyperglycemic values and increase the proportion of time within the glucose interval of 80 to 150 mg/dL.
  
  
  METHODS
  Prospective intervention study in surgical intensive care unit in a tertiary care hospital. An 11-week prealert phase was followed by a 15-week intervention phase where the S-GLY alert was alerting the nurses through the Clinical Notification System of the Intensive Care Information System.
  
  
  RESULTS
  Overall, 2335 S-GLY alerts were recorded. There were less hyperglycemic values and less persistent hyperglycemic episodes in the alert phase (19.5% vs 26.5% [P < .001] and 9.9% vs 15.4% [P < .001], respectively). More time was spent within target glucose interval (82.3% vs 75.0%, P = .009). A lower proportion of patients experienced a new-onset hypoglycemic event (<70 mg/dL) in the alert phase (9.2% vs 15.2%, P = .016). The Sequential Organ Failure Assessment score was significantly reduced (5.2 vs 4.2, P < .001).
  
  
  CONCLUSIONS
  The implementation of a real-time smart electronic glycemia alert resulted in significantly less episodes of persistent hyperglycemia and a higher proportion of time with normoglycemia, while decreasing the number of hypoglycemic events.
authors.affiliation: Department of Intensive Care, Ghent University Hospital, Ghent, Belgium. Electronic address: Kirsten.Colpaert@Ugent.be.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Colpaert
authors.affiliation: Department of Intensive Care, Ghent University Hospital, Ghent, Belgium. Electronic address: Sandra.Oeyen@Ugent.be.
authors.forename: Sandra
authors.initials: S
authors.lastname: Oeyen
authors.affiliation: Department of Information Technology, Ghent University Hospital, Ghent, Belgium. Electronic address: Bart.Sijnave@ugent.be.
authors.forename: Bart
authors.initials: B
authors.lastname: Sijnave
authors.affiliation: Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium. Electronic address: Renaat.Peleman@ugent.be.
authors.forename: Renaat
authors.initials: R
authors.lastname: Peleman
authors.affiliation: Department of Intensive Care, Ghent University Hospital, Ghent, Belgium. Electronic address: DominiqueBenoit@Ugent.be.
authors.forename: Dominique
authors.initials: D
authors.lastname: Benoit
authors.affiliation: Department of Intensive Care, Ghent University Hospital, Ghent, Belgium. Electronic address: Johan.Decruyenaere@Ugent.be.
authors.forename: Johan
authors.initials: J
authors.lastname: Decruyenaere
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D056902:Clinical Alarms / Q000706:statistics & numerical data*; D065187:Controlled Before-After Studies / Q000379:methods; D016638:Critical Illness; D005260:Female; D006706:Homeostasis; D006751:Hospital Information Systems; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000517:prevention & control*; D007003:Hypoglycemia / Q000097:blood / Q000517:prevention & control*; D007004:Hypoglycemic Agents; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D063305:Organ Dysfunction Scores; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents
keywords: Clinical decisions support systems; Computer systems; Glucose control; Health information technology; Intensive care unit