Evaluation of blood glucose control in ICU patients with Space GlucoseControl: a European study

J Blaha

doi:10.1186/cc13628

Abstract

Regardless of the ongoing debate on optimum target ranges, glycaemia control (GC) remains an important therapeutic goal in critically ill patients. Dozens of different insulin protocols for ICUs have been developed with different complexity, effectiveness, blood glucose (BG) variability and safety. Although comparison of existing protocols is difficult due to significant differences in processes and outcome measures, computerized clinical decision support systems generally achieved better GC with consistently lower hypoglycaemia rates than that achieved with paper-based protocols [1]. The enhanced Model Predictive Control (eMPC) algorithm, developed by the CLINICIP group, is the effective clinically proven protocol, which has been successfully tested at multiple institutions on medical and surgical patients with different nutritional protocols [2,3]. The eMPC models the behaviour of glucose and insulin in ICU patients with a variable sample interval based on the accuracy of the BG prediction. It has been integrated in the B.Braun Space GlucoseControl (SGC) system, which allows direct data communication between pumps and Space Control with the incorporated eMPC algorithm. Although SGC is already clinically used in dozens of ICUs worldwide, there are few only published experiences with its use [4].

Highlights

We aimed to audit the prescribing practice on a busy 14-bedd general ICU, and develop standardised practices and tools to improve safety
There are numerous reports of critical care staff stealing controlled drugs (CDs) for personal use or financial gain and notably there have been some cases where CDs have been substituted for other medications in order to delay detection of the theft
Pediatric pharmacists have been an integral part of the PICU rounds since 2002, their role has evolved over the course of years

Summary

Introduction

We aimed to audit the prescribing practice on a busy 14-bedd general ICU, and develop standardised practices and tools to improve safety. The objective of our study was to implement a Post Arrest Consult Team (PACT) and improve the quality of care for admitted OHCA patients This retrospective audit evaluated adult patients who suffered in-hospital cardiac arrest (IHCA) against the recent National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report [1]. It looked at the recognition of the acutely unwell, the interventions made, the decisions taken from admission through to the post-arrest period and the outcomes following cardiopulmonary resuscitation (CPR). Methods We conducted a chart review of all patients admitted to the Department of Critical Care (DCC) at our hospital following cardiac arrest over 2 years in 2010 to 2012 (Group 1). Methods A retrospective review was conducted looking at SICU patients managed with a normothermia protocol, with particular

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