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Volume 15 Supplement 3

Sepsis 2011

Yale insulin protocol infusion in sepsis patients

Introduction

Tight glycemic control is a major concern in critical care. The objective of this study in the ICU was to evaluate the effectiveness and safety of the Yale insulin infusion protocol in sepsis patients.

Methods

A retrospective, before-after cohort study. Selected end-points were mean blood glucose levels, time to reach the target range of 100 to 150 mg/dl, percentage of blood glucose in the target range, and hypoglycemia incidence.

Results

Were studied 78 patients: 42 in the control group (CG) and 36 in the protocol group (PG). Bedside blood glucose was measured 3,755 times for a mean value of 134.1 ± 15.4 mg/dl in the PG versus 1,730 times for a mean value of 172.7 ± 33.6 mg/dl in the CG. Blood glucose values were in the target range 63% and 37% of the times, respectively, for the PG and the CG (P < 0.001). The median time to reach the glucose target range was 8 hours (range 5 to 17 hours) for the PG and 53 hours (range 23 to 218 hours) for the CG (P < 0.001). The incidence of severe hypoglycemia reached a statistically significant difference: one patient in the PG versus four patients in the CG (P < 0.01). All patients reached the target in 72 hours of insulin infusion in the PG while only 29 patients in the CG reached this target.

Conclusion

The Yale insulin infusion protocol was effective and safe in sepsis patients admitted to the ICU.

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Correspondence to S Oliveira.

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Oliveira, S. Yale insulin protocol infusion in sepsis patients. Crit Care 15, P5 (2011). https://doi.org/10.1186/cc10374

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Keywords

  • Blood Glucose
  • Glucose Level
  • Emergency Medicine
  • Blood Glucose Level
  • Median Time