ABSTRACT
Blaha
J, Kremen J, Anderlova K, Svacina S, Kunstyr J and Haluzik M
Increased blood glucose levels frequently occur in critically
ill patients both with and without previous presence of diabetes. Numerous
studies have shown that its normalization by intensive insulin treatment
markedly improve the outcome of critically ill patients. Several glucose
management protocols have been developed and showed different effectiveness in normalizing
blood glucose. Here we describe 3 glucose management protocols from 3 different
European cardiosurgical centers: General University Hospital in Prague, Medical
University in Graz, Royal Brompton Hospital in London and compare them with the
glucose management protocol from “Leuven study”. We further tested the
effectiveness of these protocols in 10 randomly selected patients from each
center. We show that continuous insulin infusion is a necessary prerequisite
for satisfactory blood glucose control in critically ill patients both with and
without previous history of insulin-treated diabetes. Implementation of iv
insulin boluses in combination with continuous insulin infusion did not further
improve glucose control in this study.
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