Department of Medicine, Case Western Reserve University, Cleveland, Ohio 44106, USA.
Curr Opin Clin Nutr Metab Care. 2010 Mar;13(2):198-204. doi: 10.1097/MCO.0b013e32833571db.
To provide an update on the currently available insulin infusion protocols for treatment of hyperglycemia in critically ill patients and to discuss the major differences and similarities among them.
We identified a total of 26 protocols, 20 of which used manual blood-glucose calculations, and six that used computerized algorithms. The major differences and similarities among the insulin infusion protocols were in the following areas: patient characteristics, target glucose level, time to achieve target glucose level, incidence of hypoglycemia, rationale for adjusting the rates of insulin infusion, and methods of blood-glucose measurements. Several computerized protocols hold promise for safer achievement of glycemic targets.
Insulin infusion is the most effective method for controlling hyperglycemia in critically ill patients. Clinicians should utilize a validated insulin infusion protocol that is well tolerated, and is most appropriate and practical for their institution based on the resources that are available.
提供目前用于治疗危重症患者高血糖的胰岛素输注方案，并讨论它们之间的主要差异和相似之处。
我们共确定了 26 个方案，其中 20 个使用了手动血糖计算，6 个使用了计算机算法。胰岛素输注方案之间的主要差异和相似之处在于以下几个方面：患者特征、目标血糖水平、达到目标血糖水平的时间、低血糖发生率、调整胰岛素输注率的依据以及血糖测量方法。一些计算机化的方案有望更安全地实现血糖目标。
胰岛素输注是控制危重症患者高血糖的最有效方法。根据可用资源，临床医生应根据所在机构的情况，使用耐受良好且最适合和实用的经过验证的胰岛素输注方案。
