Prednosti in slabosti različnih protokolov vodenja vrednosti glukoze v krvi pri kritično bolnih pacientih

pregled literature

  • Sedina Kalender Smajlović Fakulteta za zdravstvo Angele Boškin, Spodnji Plavž 3, 4270 Jesenice, Slovenija
Ključne besede: hiperglikemija, koncentracija glukoze v krvi, inzulinska infuzijska mešanica

Povzetek

Uvod: Medicinske sestre v enotah intenzivne terapije uravnavajo ciljno vrednost glukoze v krvi pri kritično bolnih po sprejetih in veljavnih protokolih. Namen raziskave je bil raziskati prednosti in slabosti različnih protokolov vodenja  vrednosti glukoze v krvi pri kritično bolnih.
Metode: Uporabljen je bil sistematični pregled znanstvene in strokovne literature. Iskanje literature je potekalo od 1. 2. 2017 do 8. 8. 2017. V pregled so bile vključene naslednje baze: COBIB.SI, Digitalna knjižnica Slovenije – Dlib.si, CINAHL, ProQuest, PubMed in Google Učenjak. Iskanje je potekalo z različnimi kombinacijami ključnih besed v slovenskem in angleškem jeziku: prednosti, slabosti, medicinske sestre, kritično bolni, glukoza v krvi in protokoli za vodenje vrednosti glukoze v krvi. Uporabljen je bil Boolov operater AND. Iz iskalnega nabora 1064 zadetkov je bilo v končno analizo  vključenih 15 člankov. Za obdelavo podatkov je bil uporabljen model analize konceptov.
Rezultati: Identificirana so bila tri tematska področja: (1) primernost različnih protokolov za vodenje vrednosti glukoze v krvi, (2) delovne obremenitve medicinskih sester pri teh protokolih in (3) varnost protokolov. Prednosti računalniško podprtega protokola za vodenje vrednosti glukoze v krvi so v boljšem doseganju ciljne vrednosti koncentracije glukoze v krvi, slabosti pa v pojavu odstopanj v zvezi z načrtovanim časom za merjenje glukoze v krvi.
Diskusija in zaključek: Nekatere raziskave ugotavljajo prednosti računalniško podprtih protokolov za vodenje vrednosti glukoze v krvi v smislu tehnoloških izboljšav, zmanjšanja delovnih obremenitev medicinskih sester in izboljšanja varnosti pacientov. Raziskava prispeva k izboljševanju klinične prakse pri delu s kritično bolnimi pacienti.

Biografija avtorja

Sedina Kalender Smajlović, Fakulteta za zdravstvo Angele Boškin, Spodnji Plavž 3, 4270 Jesenice, Slovenija

pred., dipl. m. s., mag. zdr. neg.

Literatura

Agency for Healthcare Research and Quality, 2012. Guidelines for the use of an insulin infusion for the management of hyperglycemia in critically ill patients. Available at: https://www.guideline.gov/summaries/summary/43905/guidelines-for-the-use-of-an-insulin-infusion-for-the-management-of-hyperglycemia-in-critically-ill-patients.[14.2.2017].

Al - Tarifi, A. & Abou – Shala, N. & Tamim, H. M. & Rishu, A. H. & Arabi, Y. M., 2013. What is the optimal blood glucose target in critically ill patients? A nested cohort study. Annals of Thoracic Medicine, 6(4), pp. 207–211.

Aragon, D., 2006. Evaluation of nursing work effort and perceptions about blood glucose testing in tight glycemic control. American Journal of Critical Care,15(4), pp. 370–377.

Aragon, D., 2013. Evaluation of nursing work effort and perceptions about blood glucose testing in tight glycemic control. American Journal of Critical Care, 15, pp. 370-377.

Boom, D.T. & Sechterberger, M.K. & Rijkenberg, S., 2014. Insulin treatment guided by subcutaneous continuous glucose monitoring compared to frequent point-of-care measurement in critically ill patients: a randomized controlled trial. Critical Care, 20;18(4), pp. 453.

Bouw, J.W. & Campbell, N. & Hull, M.A. & Juneja, R. & Guzman, O. & Overholser, B.R., 2012. A retrospective cohort study of a nurse-driven computerized insulin infusion program versus a paper-based protocol in critically ill patients. Diabetes technology & Therapeutic, 14(2), pp. 125-130.

Campion, T.R. & May, A.K., Waitman, L.R. & Ozdas, A. & Lorenzi, N.M. & Gadd, C.S., et al., 2011. Characteristics and effects of nurse dosing over-rides on computer-based intensive insulin therapy protocol performance. Journal of the American Medical Information Association, 18(3), pp. 251-258.

Carmona Monge, F.J. & Martínez Lareo, M. & García Gómez, S. & Jara Pérez, A. & Alameda Varela, R. & Quirós Herranz, C., et al., 2012. Effectiveness and safety of goal directed nurse-led blood glucose control in an intensive care unit: a prospective observational study. Enfermagem Intensiva, 23(1), pp. 11-16.

Chant, C. & Mustard, M. & Thorpe, K.E. & Friedrich, J.O., 2012. Nurse - vs Nomogram-Directed Glucose Control in a Cardiovascular Intensive Care Unit. American Journal of Critical Care, (21) 4, pp, 270-278.

Chien, W.H., 2012. Glycemic control in critically ill patients. World Journal of Critical Care Medicine, 1(1), pp. 31–39.

Clergeau, A. & Parienti, J.J. & Reznik, Y. & Clergeau, D. & Seguin, A. & Valette, X., et al., 2017. Impact of a Paper-Based Dynamic Insulin Infusion Protocol on Glycemic Variability, Time in Target, and Hypoglycemic Risk: A Stepped Wedge Trial in Medical Intensive Care Unit Patients. Diabetes Technology Therapeutic, 19(2), pp. 115-123.

Domingos Corrêa, T. & Pereira de Almeida, F. & Biasi Cavalcanti, A. & José Pereira, A. & Silva, E., 2012. Assessment of nursing perceptions of three insulin protocols for blood glucose control in critically ill patients. Available at: http://www.scielo.br/scielo.php?pid=S1679-45082012000300016&script=sci_arttext&tlng=en. [15.2.2017].

Dharmalingam, M., 2016. Glycemic control in Intensive Care Unit. Indian Journal of Endocrinology and Metabolism, 20(4), pp. 415–417.

DuBose, J.J. & Nomoto, S. & Higa, L. & Paolim, R. & Teixeira, P.G. & Inaba, K. & Demetriades, D. & Belzberg, H., 2009. Nursing involvement improves compliance with tight blood glucose control in the trauma ICU: A prospective observational study. Intensive Critical Care Nursing, 25(2), pp. 101-107.

Elderkin, T. &Orford, N. & Bailey, M. & Kaukonen, M. & Stow, P. & Cattigan, C., et al., 2015. Glycaemic trips (translation of research into practice) - Glycaemic control and long term outcomes following transition from modified Intensive Insulin Therapy to conventional glycaemic control. Australian Critical Care, 28(1), pp. 47-47.

Evans, A. & Le Compte, A. & Tan, C.S. & Ward, L. & Steel, J. & Pretty, C.G., et al., (2012). Stochastic targeted (STAR) glycemic control: design, safety, and performance. Journal of Diabetes Science and Technology, 1;6(1), pp. 102-115.

Gartemann, J. & Caffrey, E. & Hadker, N. & Crean, S. & Creed, G.M. & Rausch, C., et al., 2012. Nurse workload in implementing a tight glycaemic control protocol in a UK hospital: a pilot time-in-motion study. Nursing in Critical Care, 17(6), pp. 279-284.

Hargraves, J.D., 2014. Glycemic Control in Cardiac Surgery: Implementing an evidence – based insulin infusion protocol. American Journal of Critical Care, 23(3), pp. 250-258.

Hoekstra, M. & Schoorl, M.A. & van der Horst, I.C. &Vogelzang, M. & Wietasch, J.K. & Zijlstra, F., et al., 2010. Computer-assisted glucose regulation during rapid step-wise increases of parenteral nutrition in critically ill patients: a proof of concept study. JPEN Journal of Parenteral & Enteral Nutrition, 34(5), pp. 549-553.

Kalfon, P. & Giraudeau, B. & Ichai, C., 2014. Tight computerized versus conventional glucose control in the ICU: a randomized controlled trial. Intensive Care Medicine, 40, pp. 171-181.

Khalaila, R. & Libersky, E. & Catz, D. & Pomerantsev, E. & Bayya, A. & Linton, D. M., et al., 2011. Nurse-Led Implementation of a Safe and Effective Intravenous Insulin Protocol in a Medical Intensive Care Unit. Critical Care Nurse, 31(6), pp. 27-35.

Kim, S. & Rushakoff, R.J. & Sullivan, M. &Windham, H., 2012. Hyperglycemia control of the nil per os patient in the intensive care unit: introduction of a simple subcutaneous insulin algorithm. Journal of Diabetes Science and Tehnology, 6(6), pp. 1413–1419.

Kopecky, P. & Mraz, M. & Blaha, J. & Linder, J. & Svacina, S. & Hovorka, R., et al., 2013. The use of continuous glucose monitoring combined with computer-based eMPC algorithm for tight glucose control in cardiosurgical ICU. Biomed Research International. Available at: https://www.hindawi.com/journals/bmri/2013/186439/. [15.2.2017].

Kelly, J.L., 2014. Continuous Insulin Infusion: When, Where, and How? Diabetes Spectrum, 27(3), pp. 218–223.

Krinsley, J. S., 2015. Glycemic control in the critically ill: What have we learned since NICE-SUGAR? Hospital Practice, 43(3), pp. 191-197.

Lange, V.Z., 2010. Successful management of in-hospital hyperglycemia: the pivotal role of nurses in facilitating effective insulin use. Medsurg Nursing, 19(6): pp. 323-328.

Lee, A. & Faddoul, B. & Sowan, A. & Johnson, K.L. & Silver, K.D. & Vaidya, V., 2010. Computerisation of a paper-based intravenous insulin protocol reduces errors in a prospective crossover simulated tight glycaemic control study. Intensive Critical Care Nursing, 26(3), pp. 161-168.

Lipshutz, A.K. & Fee, C. & Schell, H. & Campbell, L. & Taylor, J. & Sharpe, B.A., et al., 2008. Strategies for success: a PDSA analysis of three QI initiatives in critical care. Joint Commission Journal on Quality and Patient Safety, 34(8), pp. 435–444.

Luiking, M.L. & van Linge, R. & Bras, L. & Grypdonck, M. & Aarts, L., 2016. Intensive insulin therapy implementation by means of planned versus emergent change approach. Nursing Critical Care, 21(3), pp. 127-136.

Marik, P.E. & Preiser, J.C., 2010. Toward understanding tight glycemic control in the ICU: a systematic review and metaanalysis. Chest, 137(3), pp. 544-551.

Medscape Critical Care, 2017. Improving Outcomes With Evidence-Based Protocols. Available at: http://www.medscape.org/viewarticle/555168. [21. 2. 2017].

The Nice Sugar Investigators, 2012. Hypoglycemia and Risk of Death in Critically Ill Patients. The New England Journal of Medicine, 367, pp. 1108-1118.

Nelson, M., 2011. Impact of a nurse – managed hyperglycemic intensive insulin protocol on glucose control. Available at: http://cardinalscholar.bsu.edu/bitstream/handle/123456789/194824/NelsonM_2011-2_BODY.pdf;jsessionid=864D3186815AF1D6263FFA0072BCE4CE?sequence=1. [14. 2. 2017].

NG, L.S. & Curley, M., 2012. One More Thing to Think about…” Cognitive Burden Experienced by Intensive Care Unit Nurses When Implementing a Tight Glucose Control Protocol. Journal of a Diabetes Science and Technology, 6(1), 58–64.

Okabayashi, T. & Kozuki, A. & Sumiyoshi, T. & Shima, Y. 2013. Technical Challenges and Clinical Outcomes of Using a Closed-Loop Glycemic Control System in the Hospital. Journal of Diabetes Science Technology. 7(1), pp. 238-246.

Pattan, V. & Parsaik, A. & Brown, J.K. & Kudva, Y.C. & Vlahakis, N. & Basu, A., 2011. Glucose control in Mayo Clinic intensive care units. Journal of Diabetes Science Technology; 5(6), pp. 1420–1426.

Penning, S. & Le Compte, A.J. & Massion, P. & Moorhead, K.T. & Pretty, C.G. & Preiser, J.C., et al., 2012. Second pilot trials of the STAR-Liege protocol for tight glycemic control in critically ill patients. Biomedical Engeniring Online, 23;11, pp. 58.

Preiser, J.C. & Chase, J.G. & Hovorka, R. & Jeffrey, I. & Joseph, J.I. & Krinsley, J.S., 2016. Glucose Control in the ICU. Journal of Diabetes Science and Technology, 10(6). Available at:

http://journals.sagepub.com/doi/full/10.1177/1932296816648713. [15.2.2017].

Sauer, P. & Van Horn, E.R., 2009. Impact of intravenous insulin protocols on hypoglycemia, patient safety, and nursing workload. Dimensions of Critical Care Nursing, 28(3), pp. 95–101.

Schultz, M.J. & Harmsen, R.E. & Korevaar, J.C. & Abu-Hanna, A. & Van Braam Houckgeest, F. & Van Der Sluijs, J.P., et al., 2012. Spronk PE. Adoption and implementation of the original strict glycemic control guideline is feasible and safe in adult critically ill patients. Minerva Anestesiologica, 78(9), pp. 982-995.

Skela Savič, B., 2009. Zdravstvena nega in raziskovanje: neKateri vplivni dejavniki za razvoj zdravstvene nege kot znanstvene discipline v Sloveniji. Obzornik zdravstvene nege, 43(3), pp. 209-222.

Stoecklin, P. & Delodder, F. & Pantet, O. & Berger, M.M., 2016. Moderate glycemic control safe in critically ill adult burn patients: A 15 year cohort study. Burns, 42(1), pp. 63-70.

Van Herpe, T. & Mesotten, D. & Wouters, P.J. & Herbots, J. & Voets, E. & Buyens, J., et al., 2013. LOGIC-insulin algorithm-guided versus nurse-directed blood glucose control during critical illness: the LOGIC-1 single-center, randomized, controlled clinical trial. Diabetes Care. 36(2), pp. 188-194.

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2018-03-14
Kako citirati
Kalender Smajlović, S. (2018) Prednosti in slabosti različnih protokolov vodenja vrednosti glukoze v krvi pri kritično bolnih pacientih, Obzornik zdravstvene nege, 52(1), str. 45-56. doi: 10.14528/snr.2018.52.1.181.
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