Abstract
Implementation of tight glycemic control in hospitalized ICU patients presents a significant health care challenge. Many patients are involved, and implementation of tight glycemic control uses many hours of critical care nursing time. The current literature provides little practical guidance, older literature offers examples of tight glycemic control protocols, and the more recent NICE-SUGAR study involved the use of a computer-driven algorithm. This article provides the critical care physician direction for the organization of blood glucose control in the ICU. Discussion of an effective, safe, and user-friendly algorithm for intravenous insulin administration is presented, and safety considerations are discussed.
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