Comparison of Insulin Protocols in Critically ill Patients
Journal of clinical and medical images and short reports
Background and Aim: This study aimed to determine the best protocol in the treatment of stress-related hyperglycemia and insulin resistance. Materials and Methods: A total of 30 patients under mechanical ventilation were included in the study. We investigated the effect of intensive insulin treatment on mortality and morbidity by performing three different insulin protocols and close glycemic control. We compared blood glucose levels, blood lipid profiles, ventilator-related pneumonia
... t, C-reactive protein levels and blood lactate levels between protocols. Results: The statistical comparison of the groups showed no difference regarding the mean age of the patients (p>0.05), APACHE II scores observed 24 hours after admission to the intensive care unit (p>0.05), and the blood glucose levels before intervention (p>0.05). As for the insulin infusion doses administrated within the 15-day follow-up period, there was no difference among groups (p=0.7752). The number of hypo-(<60mg/dl) and hyperglycemic (>117mg/dl) events observed in the Leuven, CUP and Graz protocols were statistically compared, and no significant difference was observed (p>0.05). Conclusion: All three protocols analyzed in this study may be used for glycemic control and these protocols are similarly effective in reducing CRP values, regulating blood lipid profiles and reducing the development of ventilator-related pneumonia.