Computer-assisted glucose control in critically ill patients

Mathijs Vogelzang*, Bert G. Loef, Joost G. Regtien, Iwan C. C. van der Horst, Hein van Assen, Felix Zijlstra, Maarten W. N. Nijsten

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

65 Citaten (Scopus)
164 Downloads (Pure)


Objective: Intensive insulin therapy is associated with the risk of hypoglycemia and increased costs of material and personnel. We therefore evaluated the safety and efficiency of a computer-assisted glucose control protocol in a large population of critically ill patients. Design and setting: Observational cohort study in three intensive care units (32 beds) in a 1,300-bed university teaching hospital. Patients: All 2,800 patients admitted to the surgical, neurosurgical, and cardiothoracic units; the study period started at each ICU after implementation of Glucose Regulation for Intensive Care Patients (GRIP), a freely available computer-assisted glucose control protocol. Measurements and results: We analysed compliance in relation to recommended insulin pump rates and glucose measurement frequency. Patients were on GRIP-ordered pump rates 97% of time. Median measurement time was 5 min late (IQR 20 min early to 34 min late). Hypoglycemia was uncommon (7% of patients for mild hypoglycemia, <3.5 mmol/l; 0.86% for severe hypoglycemia, <2.2 mmol/l). Our predefined target range (4.0 - 7.5 mmol/l) was reached after a median of 5.6h (IQR 0.2 - 11.8) and maintained for 89% (70 - 100%) of the remaining stay at the ICU. The number of measurements needed was 5.9 (4.8 - 7.3) per patient per day. In-hospital mortality was 10.1%. Conclusions: Our computer-assisted glucose control protocol provides safe and efficient glucose regulation in routine intensive care practice. A low rate of hypoglycemic episodes was achieved with a considerably lower number of glucose measurements than used in most other schemes.

Originele taal-2English
Pagina's (van-tot)1421-1427
Aantal pagina's7
TijdschriftIntensive Care Medicine
Nummer van het tijdschrift8
StatusPublished - aug.-2008

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