Insulin Therapies in ICU
By Prestaciones Médicas RCCC
This application calculates the insulin requirements required by hospitalized hyperglycemic patients. Two different therapeutic regimens and routes of administration are proposed. Intravenous insulin, recommended in unstable critical patients (ICU), and subcutaneous - intensive pattern - in those stable patients who tolerate oral intake or enteral nutrition. For the elaboration of these calculators I have based on the algorithm of the NICE-SUGAR clinical trial, arm of the study that demonstrated a decrease in the mortality of patients admitted to the ICU if blood glucose levels between 140-180 mg / dl were maintained. In stable patients, I have followed the classic recommendations that show that intensive subcutaneous insulin regimens, which aim to reach prepandrial figures between 90-130 mg / dL, improve the prognosis of both diabetic and non-diabetic patients. The dose adjustment of intravenous insulin takes into account the trend (ascending or descending) produced in the last hour of treatment and the amount of insulin responsible for this variation. The bibliography and formulas used in the calculation and adjustment of doses are attached.
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