Intensive Care Clinical Unit, University Hospital Virgen Macarena, Dr. Fedriani St., 3, 41009, Seville, Spain.
Intensive Care Clinical Unit, University Hospital Virgen Macarena, Dr. Fedriani St., 3, 41009, Seville, Spain; Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Avenzoar St., 6, 41009, Seville, Spain.
Aust Crit Care. 2022 Mar;35(2):136-142. doi: 10.1016/j.aucc.2021.03.001. Epub 2021 May 5.
Hyperglycaemia is a very common complication in post-cardiac surgical patients, and as such, it must be properly managed. For this purpose, the enhanced Model Predictive Control algorithm for glycaemia control has been implemented into a nurse-led device called Space GlucoseControl (SGC) that aims to achieve a safe and effective blood glucose control in a better way than the traditional "paper-based" protocols.
The aim of the study was to know the effectiveness and safety of the SGC in glycaemia control in cardiosurgical adult patients in the immediate postoperative period in the intensive care unit.
A prospective before-and-after intervention study was conducted. One hundred sixty cardiosurgical adult patients with hyperglycaemia were selected: 80 in the control group from May to November 2018 and 80 in the intervention group (use of the SGC device) from January to December 2019. The primary outcome was the percentage of time within the target range (140-180 mg/dL in the control group and 100-160 mg/dL in the intervention group).
The percentage of time within the target range was significantly higher in the SGC group than in the control group (70.5% [58.25-80] vs 54.83% [36.09-75], p < 0.001). The range was also achieved earlier with the SGC (5 [3-6.875] hours vs 7 [4-11] hours; p < 0.05). The first blood glucose value after reaching the target range was higher in the control group, with statistical significance (p < 0.05). There were no hypoglycaemia episodes in the control group. However, during SGC treatment, six episodes of hypoglycaemia occurred, and all of them were nonsevere (mean value = 61 mg/dL).
The SGC is useful to achieve a faster tight glycaemic control, with a higher percentage of time within the target range, although episodes of nonsevere hypoglycaemia could be observed.
高血糖是心脏手术后患者非常常见的并发症，因此必须进行妥善管理。为此，一种用于血糖控制的强化模型预测控制算法已被应用于一种名为 Space GlucoseControl（SGC）的护士主导设备中，该设备旨在比传统的“基于纸张”的方案更安全有效地控制血糖。
本研究旨在了解 SGC 在心脏外科成年患者术后即刻入住重症监护病房时血糖控制中的有效性和安全性。
进行了一项前瞻性的干预前后研究。选择了 160 名患有高血糖的心脏外科成年患者：对照组 80 例，为 2018 年 5 月至 11 月，干预组（使用 SGC 设备）80 例，为 2019 年 1 月至 12 月。主要结局指标为目标范围内的时间百分比（对照组为 140-180mg/dL，干预组为 100-160mg/dL）。
SGC 组的目标范围内时间百分比明显高于对照组（70.5%[58.25-80]与 54.83%[36.09-75]，p<0.001）。SGC 组更早达到目标范围（5[3-6.875]小时与 7[4-11]小时；p<0.05）。达到目标范围后首次血糖值在对照组中更高，具有统计学意义（p<0.05）。对照组未发生低血糖事件。然而，在 SGC 治疗期间，发生了 6 例低血糖事件，均为非严重事件（平均值=61mg/dL）。
SGC 有助于更快地实现严格的血糖控制，目标范围内的时间百分比更高，尽管可能会出现非严重的低血糖事件。
