| Reduction in Hypoglycemic Events in Critically Ill Patients on Continuous Insulin Following Implementation of a Treatment Guideline. | |
| | |
MedLine Citation:
|
PMID: 22207015 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
BACKGROUND:: Hyperglycemia is common in critically ill children and appears to be associated with poor outcomes. However, the incidence of hypoglycemia while attempting glycemic control using an insulin infusion may be as high as 25% and hypoglycemia may be an independent risk factor for mortality in critically ill children. METHODS:: An improvement team developed a guideline for initiation and maintenance of insulin infusions for hyperglycemia in critically ill, nondiabetic patients in the pediatric intensive care unit. The guideline included an insulin infusion algorithm that provided an initiating dose, titration instructions, and discontinuation parameters. Guideline recommendations addressed the frequency of bedside blood glucose monitoring and management of symptomatic hypoglycemia while on insulin infusion. The guideline was implemented in late January 2007 and revised in September 2007. RESULTS:: Hypoglycemic events in at-risk patients decreased significantly following implementation of the guideline, from 36% to 3%, despite an increase in the total number of patient days on insulin infusion. The average days between hypoglycemic events increased from 21 to 186. CONCLUSIONS:: Implementation of a guideline to manage critical illness hyperglycemia in nondiabetic, critically ill pediatric patients resulted in a reduction in hypoglycemic events and a sustained increase in the days between such events. |
| | |
Authors:
|
Ranjit S Chima; Pamela J Schoettker; Kartik R Varadarajan; Elizabeth Kloppenborg; Tamara K Hutson; Richard J Brilli; David R Repaske; Michael Seid |
Related Documents
:
|
21584165 - Demographic, breast-feeding, and nutritional trends among children with type 1 diabetes... 22144215 - Changes in inflammatory biomarkers after successful lifestyle intervention in obese chi... 10837695 - Pathogenesis, prediction and trials for the prevention of insulin-dependent (type 1) di... 22523295 - Retinal and renal vascular permeability changes caused by stem cell stimulation in allo... 8071185 - Influence of chromium picolinate on glucose usage and metabolic criteria in growing hol... 21270275 - Adiponectin pretreatment counteracts the detrimental effect of a diabetic environment o... |
Publication Detail:
|
Type: JOURNAL ARTICLE |
Journal Detail:
|
Title: Quality management in health care Volume: 21 ISSN: 1550-5154 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
|
Created Date: 2011-12-30 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9306156 Medline TA: Qual Manag Health Care Country: - |
Other Details:
|
Languages: ENG Pagination: 20-28 Citation Subset: - |
Affiliation:
|
Division of Critical Care Medicine (Dr Chima), James M. Anderson Center for Health Systems Excellence (Mss Schoettker and Kloppenborg, Mr Varadarajan, and Dr Seid), Division of Pharmacy (Dr Hutson), and Division of Pulmonary Medicine (Dr Seid), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; and Division of Critical Care Medicine and Hospital Administration (Dr Brilli), and Division of Endocrinology, Metabolism and Diabetes (Dr Repaske), Nationwide Children's Hospital, The Ohio State University Columbus, Ohio. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Feasibility of real-time satisfaction surveys through automated analysis of patients' unstructured c...
Next Document: Using quality improvement methods at the system level to improve hospital emergency department treat...