Hyperglycemia
Conditions
Keywords
Tight glycemia control, cardiac surgery patients
Brief summary
A randomized trial to compare three insulin-titration protocols for tight glycemic control in surgical ICU: an absolute glucose (Matias) protocol, a relative glucose change (Bath) protocol, and an enhanced model predictive control algorithm (eMPC)
Detailed description
120 consecutive post-cardiac surgery patients randomized to the three protocols with a target glycemia range from 4.4 to 6.1 mmol/l. Intravenous insulin was administered continuously or in combination with insulin boluses (Matias protocol). Blood glucose was measured in 1-4 hour intervals as requested by protocols.
Interventions
Insulin was was administered according to each protocol rules/suggestions into a central venous line as a continuous infusion (Bath and eMPC protocols) or as a combination of a continuous infusion and boluses (Matias protocol). A standard concentration of 50 IU of insulin in 50 ml of 0.9% NaCl was used. In all patients, infusion of 10% glucose solution was initiated upon admission to ICU with glucose dose of 2.5 g/kg of ideal body weight (height in centimetres minus 100) per hour and lasted for 18 hours, when normal oral food intake was started. In ventilated patients, the glucose infusion lasted for 48 hours, and then standard enteral nutrition was initiated.
Sponsors
Study design
Eligibility
Inclusion criteria
* patients admitted to the postoperative ICU after elective cardiac surgery
Exclusion criteria
* insulin allergy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The effectiveness of different TGC management protocols | ICU stay |
Secondary
| Measure | Time frame |
|---|---|
| The safety with respect to hypoglycemia | ICU stay |
Countries
Czechia