The effectiveness of a computerized IV infusion protocol to treat hyperglycemia in burn patients

Rajiv Sood, Madeline Zieger, David Roggy, Muhammad Nazim, Stacy R. Henderson, Brett Hartman

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Tight glucose control (TGC) in critical care settings is becoming increasingly the standard of care. However, TGC comes with the risk of hypoglycemia, as highlighted by some recent studies. Our aim was to establish TGC in burn patients without increasing rates of hypoglycemia. The authors used a computer-driven glucose control program (CGS) to achieve this goal. The computer program calculates insulin drip rates by using a multiplier that changes according to blood glucose (BG) values as well as trends and keeps a record of BG data and insulin infusion rates for future quality control analysis. CGS is also a useful adjunct in transitioning patients from an IV insulin drip to subcutaneous insulin. A retrospective review of the glucose control program database was performed to obtain information on length of time to goal glucose levels (set at 100-150 mg/dl), glucose level trends, and incidence of hypoglycemia when using the computer program. Over 18 months, we used CGS on 94 critical and noncritical burn patients. Mean time to target BG was 5.1 hours. Glucose levels of 100 to 150 mg/dl were maintained 63.3% of the time, and values within the wider range of 70 to 150 mg/dl were maintained 80.8% of the time. The incidence of hypoglycemia, defined as BG level below 70 mg/dl, was only 1.66% and was treated without any adverse sequelae. Hyperglycemic episodes were directly correlated with surgical interventions during which time the CGS was not utilized in the operating room. CGS offers a safe and effective means of rapidly achieving and maintaining glucose targets in burn patients. Further analysis of the data needs to be conducted to determine whether the BG targets used in our study offer a morbidity benefit to burn patients.

Original languageEnglish
Pages (from-to)638-641
Number of pages4
JournalJournal of Burn Care and Research
Volume33
Issue number5
DOIs
StatePublished - Sep 2012

Fingerprint

Hyperglycemia
Glucose
Blood Glucose
Hypoglycemia
Insulin
Software
Incidence
Operating Rooms
Critical Care
Standard of Care
Quality Control
Databases
Morbidity

ASJC Scopus subject areas

  • Emergency Medicine
  • Rehabilitation
  • Surgery

Cite this

The effectiveness of a computerized IV infusion protocol to treat hyperglycemia in burn patients. / Sood, Rajiv; Zieger, Madeline; Roggy, David; Nazim, Muhammad; Henderson, Stacy R.; Hartman, Brett.

In: Journal of Burn Care and Research, Vol. 33, No. 5, 09.2012, p. 638-641.

Research output: Contribution to journalArticle

Sood, Rajiv ; Zieger, Madeline ; Roggy, David ; Nazim, Muhammad ; Henderson, Stacy R. ; Hartman, Brett. / The effectiveness of a computerized IV infusion protocol to treat hyperglycemia in burn patients. In: Journal of Burn Care and Research. 2012 ; Vol. 33, No. 5. pp. 638-641.
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