Diener José Roberto Carvalho, Prazeres Carlos Eduardo Elias Dos, Rosa Cilmar Mello da, Alberton Urubatan Collaço
UFSC.
Universidade Federal de Santa Catarina.
Rev Bras Ter Intensiva. 2006 Sep;18(3):268-75.
Actually tight glycemic control is a major concern in critical care. The objective of this study was to evaluate effectiveness and safety of Yale insulin infusion protocol in a Brazilian medical and surgical intensive care unit.
Retrospective, before-after cohort study. Selected end-points were mean blood glucose levels, time-to-reach target range of 80 - 140 mg/dL, and percent of blood glucose in target range and hypoglycemia incidence.
Were studied 112 patients: 60 in control group (CG) and 52 in protocol group (PG). Bedside blood glucose was measured 5392 times for a mean value of 131.2 ± 14.7 mg/dL in the PG versus 2485 times for a mean value of 181.7 ± 36.1 mg/dL in the CG. Blood glucose values were in the target range 65% and 32% of the times, respectively for PG and CG groups (p < 0.001). The median time to reach glucose target range was 7 h (range 4 -10 h) for PG and 96 hr (range 46 - 278 h) for CG (p < 0.001). Incidence of severe hypoglycemia did not reach difference statistically significant: 4 patients in PG versus 2 patients in CG.
Yale insulin infusion protocol was effective and safe to improve blood glucose control in a Brazilian medical and surgical intensive care unit.
在重症监护中，严格的血糖控制实际上是一个主要关注点。本研究的目的是评估耶鲁胰岛素输注方案在巴西一家内科和外科重症监护病房中的有效性和安全性。
回顾性前后队列研究。选定的终点指标为平均血糖水平、达到80 - 140 mg/dL目标范围的时间、血糖处于目标范围内的百分比以及低血糖发生率。
共研究了112例患者：对照组（CG）60例，方案组（PG）52例。PG组进行了5392次床旁血糖测量，平均值为131.2±14.7 mg/dL；CG组进行了2485次测量，平均值为181.7±36.1 mg/dL。PG组和CG组血糖值分别有65%和32%的时间处于目标范围内（p < 0.001）。PG组达到血糖目标范围的中位时间为7小时（范围4 - 10小时），CG组为96小时（范围46 - 278小时）（p < 0.001）。严重低血糖的发生率无统计学显著差异：PG组4例，CG组2例。
耶鲁胰岛素输注方案在巴西一家内科和外科重症监护病房中有效且安全地改善了血糖控制。
