Blood Sugar Management In Icu

Intensive blood glucose protocols goal of 81 to 108 mg per dl 450 to 599 mmol per l for patients in the icu increase mortality compared with less intensive treatment ie goal of 180 mg per.

Blood sugar management in icu. The goal of the protocol is to maintain blood glucose levels lower than 140 mgdl. Discuss advantages of nurse directed blood glucose management. The glycemic management protocol was written by a multidisciplinary group of physicians and nurses and it is a nurse driven protocol whereby nurses administer insulin without a physicians order based on the parameters of the protocol. During their icu stays 987 of patients in the intensive insulin therapy group required insulin infusions and the targeted blood glucose level was achieved with a mean blood glucose of 103 mgdl.

Continuing education disclosure statement. Relationships between blood glucose concentration and outcome and also the optimum management of blood glucose remain highly contentious issues for critical care practitioners. Among the many controversies is whether critically ill patients with diabetes should be treated differently from those without diabetes. Routine management in icu involves avoiding complications of hyperglycaemia infections and hypoglycaemia arrhythmias neurological damage cardiac events traditional goals have varied tight glucose control was in vogue following the leuven trials led by greet van den berghe but this was over turned by the subsequent definitive nice sugar trial.

Intensive insulin therapy is a treatment approach designed to keep your blood sugar levels closer to the levels of someone who doesnt have diabetes. All patients reverted to conventional blood glucose management upon discharge from the icu. This treatment requires close monitoring of blood sugar levels and multiple doses of insulin. Hyperglycemia blood glucose 200 mgdl 122 mmoll was present in 255 patients 25 percent at the time of icu admission.