Effectiveness, safety and feasibility of an evidence-based insulin infusion protocol targeting moderate glycaemic control in intensive cardiac care units

European Heart Journal. Acute Cardiovascular Care
Fausto AvanziniDesio Diabetes Diagram (DDD) study group

Abstract

To assess the effectiveness, safety and feasibility of the revised, simplified nurse-managed version of our insulin infusion protocol, adapted to the new recommended glycaemic target of 140 to 180 mg/dL (Desio Diabetes Diagram i.v. 140-180). All clinical responses to the Desio Diabetes Diagram i.v. 140-180 in use for 3 years were recorded in patients with diabetes or hyperglycaemia admitted to our intensive cardiac care unit. To assess the feasibility, we asked nurses to complete an ad hoc questionnaire anonymously when the new insulin infusion protocol had been in use for 2 years. From December 2010 to December 2013, 276 patients (173 men, median age 75 years) were treated according to the Desio Diabetes Diagram i.v. 140-180. The median time to reach glycaemic target was 4 h (Q1-Q3 2-8) in 128 patients with blood glucose >180 mg/dL and 2 h (Q1-Q3 1-4) in 82 patients with blood glucose <140 mg/dL. Once the target had been reached, insulin infusion was maintained for a median of 38 h (Q1-Q3 24-48) with blood glucose between 140 and 180 mg/dL for 58.3% of the infusion time. Over a total of 11,863 h of infusion, seven blood glucose <70 mg/dL occurred. The Desio Diabetes Diagram i.v. 140-180 protocol was considered easy to use by 9...Continue Reading

References

Jan 17, 2002·The New England Journal of Medicine·G van den BergheR Bouillon
Feb 3, 2006·The New England Journal of Medicine·Greet Van den BergheRoger Bouillon
Feb 8, 2007·Cardiovascular Diabetology·Iwan C C van der HorstFelix Zijlstra
Nov 29, 2007·JAMA : the Journal of the American Medical Association·Rafael DíazSalim Yusuf
Jan 11, 2008·The New England Journal of Medicine·Frank M BrunkhorstUNKNOWN German Competence Network Sepsis (SepNet)
Apr 5, 2008·Intensive Care Medicine·Mathijs VogelzangMaarten W N Nijsten
Jan 31, 2009·European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology·Fausto AvanziniUNKNOWN DDD study group
Mar 26, 2009·The New England Journal of Medicine·Simon FinferJuan J Ronco
May 26, 2009·Lancet·Kathleen M DunganJean-Charles Preiser
Dec 26, 2009·Critical Care Medicine·Jeroen HermanidesJ Hans Devries
Dec 31, 2009·Current Opinion in Clinical Nutrition and Metabolic Care·Armand KrikorianEtie S Moghissi
Jan 27, 2011·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Joe Krenitsky
Oct 28, 2011·BMJ : British Medical Journal·A SenthinathanUNKNOWN Guideline Development Group
Dec 6, 2011·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Shilpa ShettyShyoko Honiden
Jan 3, 2012·Diabetes & Metabolism·B VergèsUNKNOWN Diabetes and Cardiovascular Disease study group of the Société francophone du diabète (SFD), in collaboration with the Socié
Aug 28, 2012·European Heart Journal·UNKNOWN Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC)Doron Zahger
Jan 22, 2013·Journal of the American College of Cardiology·Alexandre MebazaaUNKNOWN GREAT Network
May 3, 2014·American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses·Joelle D Hargraves
Dec 30, 2014·Diabetes Care·UNKNOWN American Diabetes Association

❮ Previous
Next ❯

Citations

Mar 8, 2020·Diabetic Medicine : a Journal of the British Diabetic Association·F AvanziniUNKNOWN Desio Diabetes Diagram (DDD) Study Group

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.