The effects of insulin infusion protocol on the glycemic level of the intensive care patients

Jihan, Zukhi and Fatanah Mohamad, Suhaimi and Mohd Zulfakar, Mazlan and Ummu Kulthum, Jamaludin and Normy, Razak and Mastura, Mohd Sopian (2020) The effects of insulin infusion protocol on the glycemic level of the intensive care patients. In: IFAC-PapersOnLine; 21st IFAC World Congress 2020, 12-17 July 2020 , Berlin. pp. 15964-15969., 53 (2). ISSN 2405-8963

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Insulin infusion protocol is the standard protocol that has been practiced in Malaysia's intensive care unit (ICU) for controlling the hyperglycemia. Multiple sliding scale method of the insulin infusion protocol may drive conflict in selecting an appropriate scale to be applied to the patient. The objective of this paper is to analyse the blood glucose outcome of eight sliding scales insulin infusion protocol adopted in the Universiti Sains Malaysia Hospital (HUSM). A retrospective data of 78 ICU patients of HUSM were fitted using a validated glucose-insulin system to identify insulin sensitivity profiles of the patients. Then, these SI profiles were simulated on various scale protocols. The results obtained from this study showed that among eight scales, Scale 4 had the highest percentage of BG within the HUSM's target of 6.0-10.0 mmol/L. Scale 1 had the highest percentage of BG for the BG measurement more than 10.0 mmol/L while Scale 8 had the highest percentage of BG measurement of less than 6.0 mmol/L. However, none of the scale shown better performance than the current clinical practice. Furthermore, all of the eight scales had a more substantial number of BG measurement compared to the clinical. This study shows that Scale 2 and Scale 3 result in a similar outcome. Similarly, Scale 5 is almost the same as Scale 6. Thus, at least two sets of scale can be combined to reduce the number of scales. The reduction of scales consequently avoid confusion and helps the clinician in selecting the appropriate scale to be applied to the patients. From this study, it can be concluded that the HUSM protocol is a combination of scales. The scales may be shifted from one to another scale depending on patient condition and clinician judgement. A proper guideline for the scale shifting seems necessary to allow optimum glycemic management in the ICU.

Item Type: Conference or Workshop Item (Lecture)
Additional Information: Indexed by Scopus
Uncontrolled Keywords: Critical care; Glycemic control; HUSM; Intensive care unit; Model-based glycemic control
Subjects: R Medicine > RC Internal medicine
R Medicine > RM Therapeutics. Pharmacology
T Technology > TJ Mechanical engineering and machinery
Faculty/Division: Faculty of Mechanical and Automotive Engineering Technology
Depositing User: Mr Muhamad Firdaus Janih@Jaini
Date Deposited: 18 Oct 2022 07:38
Last Modified: 18 Oct 2022 07:38
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