Evaluation of an ICU Hyperglycemia Protocol Using Insulin Aspart
Evaluation of an ICU Hyperglycemia Protocol Using Insulin Aspart
In response to the evidence supporting "tight" glucose control (70 - 110) in the critical
 care setting, the MMH ICU developed a protocol utilizing regular intravenous insulin. This
 protocol was initiated in 2002. Monitoring of the data collected revealed effective glycemic
 control when this protocol was used. However, limited utilization has led to overall
 ineffective glycemic control in this ICU. The poor utilization is largely due to a general
 reluctance of physicians to start their patients on an intravenous insulin infusion. As
 contributing to this poor compliance is the "open" nature of the ICU. The MMH ICU is an
 "open" ICU, meaning that many physicians across multiple subspecialties admit to this unit.
 Approaches to controlling hyperglycemia vary greatly, depending largely upon the treating
 physician. In an attempt to improve overall glycemic control in this "open" ICU, the
 Subcutaneaous Insulin Aspart Hyperglycemia Protocol (SIAP) was developed which incorporates a
 subcutaneous insulin aspart regimen that triggers the use of a regular insulin infusion
 protocol when the SIAP is not adequately controlling the patient's blood glucose.

 This study aims to evaluate 1) the effect the SIAP on overall glycemic control in the ICU, 2)
 the effectiveness that the SIAP has on controlling blood glucose as compared with past
 practices using regular insulin, and 3) the effect the SIAP has on patient complications and
 outcomes in the MMH ICU.
Inclusion Criteria: Valid physician order of the protocol. -

 Exclusion Criteria: No valid phycician order for the protocol

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