TITLE

Intensive Insulin Therapy in Critical Care Settings

AUTHOR(S)
Eastman, Darla Klug; Bottenberg, Michelle M.; Hegge, Karly A.; Ourth, Heather; Kabadi, Udaya
PUB. DATE
January 2009
SOURCE
Current Clinical Pharmacology;Jan2009, Vol. 4 Issue 1, p71
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Hyperglycemia in hospitalized patients has been shown to increase both morbidity and mortality, regardless of the presence of preexisting diabetes. In order to achieve recommended glycemic goals, many patients require the use of intravenous insulin therapy in the critical care setting. Following the publication of a landmark trial evaluating the benefits of intensive insulin therapy in critically ill patients, a worldwide increased effort to achieve strict glycemic control has ensued. Maintaining blood glucose levels between 80 and 110 mg/dL has been shown to improve outcomes such as mortality and infectious complications in critically ill patients, while also decreasing length of hospital stay and healthcare expenditures. However, achieving strict glycemic control has proven to be a challenge for many institutions, partly due to the prevalence of hypoglycemia. As demonstrated by studies which have been terminated prematurely due to increased risk for hypoglycemic episodes, the benefits versus risks of intensive insulin therapy must be weighed carefully. Patients receiving continuous infusions of insulin require close monitoring, which may increase workload for intensive care unit staff. In an effort to balance the risks and benefits of intensive insulin therapy, many hospitals are incorporating standardized protocols and using an interdisciplinary approach toward patient care.
ACCESSION #
60435371

 

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