RESUMO
Objetivo valorar la eficacia y seguridad de un sistema de control de la glucemia guiada por objetivo en una UCI. Metodología estudio descriptivo prospectivo de 13 meses. Se recogieron diariamente los valores de todas las determinaciones de glucemia en los pacientes con perfusión continua de insulina. Resultados se recogieron 12.677 glucemias realizadas a 69 pacientes en tratamiento con insulina intravenosa; el 57,9% se encontraron en el rango objetivo (100-140mg/dl); no hubo ninguna glucemia menor de 40mg/dl y tan solo el 0,2% de ellas se encontraron entre 40-60mg/dl. Conclusiones para un adecuado control de las cifras de glucemia mediante el empleo de terapia con insulina intravenosa es esencial el manejo individualizado de la perfusión de insulina, ajustándose a las características de cada paciente individual. El método guiado por objetivos que planteamos ha permitido obtener mejores resultados que los de otros estudios (AU)
Objective to evaluate the effectiveness and safety of a nurse-led blood glucose control protocol in a medical ICU. Method a descriptive, prospective study was carried out for a period of 13 months. All blood glucose values from patients on insulin therapy for intensive glycemic control were recorded daily. Results A total of 12,677 blood glucose determinations were performed on the 69 patients under glycemic control; 57.9% of the determinations had predetermined study target values for blood glucose (100-140mg/dl) and 68.8% of the determinations had physiological blood glucose values (80-140mg/dl); no values under 40mg/dl were obtained, and only 0.2% were between 40-60mg/dl. Conclusions For an adequate blood glucose control using intensive insulin therapy, individual management of insulin infusion regimen is essential, adjusted to the characteristics of each patient. A nurse-led intervention has allowed better results to be obtained in comparison with other studies in which different protocols for insulin infusion are used (AU)
Assuntos
Humanos , Cuidados Críticos/métodos , Monitorização Fisiológica/métodos , Hiperglicemia/prevenção & controle , Índice Glicêmico , Sistemas de Infusão de Insulina , Hospitalização/estatística & dados numéricosRESUMO
OBJECTIVE: to evaluate the effectiveness and safety of a nurse-led blood glucose control protocol in a medical ICU. METHOD: a descriptive, prospective study was carried out for a period of 13 months. All blood glucose values from patients on insulin therapy for intensive glycemic control were recorded daily. RESULTS: A total of 12,677 blood glucose determinations were performed on the 69 patients under glycemic control; 57.9% of the determinations had predetermined study target values for blood glucose (100-140 mg/dl) and 68.8% of the determinations had physiological blood glucose values (80-140 mg/dl); no values under 40 mg/dl were obtained, and only 0.2% were between 40-60 mg/dl. CONCLUSIONS: For an adequate blood glucose control using intensive insulin therapy, individual management of insulin infusion regimen is essential, adjusted to the characteristics of each patient. A nurse-led intervention has allowed better results to be obtained in comparison with other studies in which different protocols for insulin infusion are used.
