Effectiveness, safety and feasibility of an evidence-based insulin infusion protocol targeting moderate glycaemic control in intensive cardiac care units
Objectives: To assess the effectiveness, safety and feasibility of the revised, simplified nurse-managed version of our insulin infusion protocol, adapted to the new recommended glycaemic target of 140 to 180 mg/dL (Desio Diabetes Diagram i.v. 140–180). Methods: All clinical responses to the Desio D...
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| Veröffentlicht in: | European heart journal. Acute cardiovascular care 2016-04, Vol.5 (2), p.117-124 |
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| creator | Avanzini, Fausto Marelli, Giuseppe Saltafossi, Donata Longhi, Chiara Carbone, Stefania Carlino, Liliana Planca, Enrico Vilei, Veronica Roncaglioni, Maria Carla Riva, Emma Avanzini, F. Balestri, G. Bertocchi, P. Chiappa, L. Corticelli, A. Faricelli, S. Iacuitti, G. Mantovani, G. Moro, C. Mollichelli, N. Planca, E. Rogatska, R. Saltafossi, D. Schiavina, R. Tresoldi, S. Vandoni, P. Amodeo, R. Baldo, S. Bertazzolo, J. Bottan, S.L. Busi, G. Carbone, S. Carlino, L. Caspani, M. Ciceri, R. Ciotta, L. Cotza, R. D’Amato, D. Grassi, C. De Ponti, A. Di Rocco, E. Donè, V. Feliciano, F. Frigerio, I. Gagliardi, A.M. Ilardi, M. Ledda, A. Lippi, B. Longhi, C. Mamo, R.M. Mancuso, M.A. Maniscalco, G. Palazzo, E. Pellegrino, D. Pintonello, D. Pugliese, U. Radaelli, C. Stelluti, G. Stercoli, M.C. Sutera, S. Tonelli, L. Tullio, F. Battaglia, E. Maida, A. Mandolaro, D. Sala, P. Stillitano, F. Marelli, G. Vilei, V. Rumi, P. Bellato, L. Fedeli, M. Merlini, A. Pinelli, G. Colombo, E. De Luca, E. Galimberti, C. |
| description | Objectives:
To assess the effectiveness, safety and feasibility of the revised, simplified nurse-managed version of our insulin infusion protocol, adapted to the new recommended glycaemic target of 140 to 180 mg/dL (Desio Diabetes Diagram i.v. 140–180).
Methods:
All clinical responses to the Desio Diabetes Diagram i.v. 140–180 in use for 3 years were recorded in patients with diabetes or hyperglycaemia admitted to our intensive cardiac care unit. To assess the feasibility, we asked nurses to complete an ad hoc questionnaire anonymously when the new insulin infusion protocol had been in use for 2 years.
Results:
From December 2010 to December 2013, 276 patients (173 men, median age 75 years) were treated according to the Desio Diabetes Diagram i.v. 140–180. The median time to reach glycaemic target was 4 h (Q1–Q3 2–8) in 128 patients with blood glucose >180 mg/dL and 2 h (Q1–Q3 1–4) in 82 patients with blood glucose |
| doi_str_mv | 10.1177/2048872615574110 |
| format | Article |
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To assess the effectiveness, safety and feasibility of the revised, simplified nurse-managed version of our insulin infusion protocol, adapted to the new recommended glycaemic target of 140 to 180 mg/dL (Desio Diabetes Diagram i.v. 140–180).
Methods:
All clinical responses to the Desio Diabetes Diagram i.v. 140–180 in use for 3 years were recorded in patients with diabetes or hyperglycaemia admitted to our intensive cardiac care unit. To assess the feasibility, we asked nurses to complete an ad hoc questionnaire anonymously when the new insulin infusion protocol had been in use for 2 years.
Results:
From December 2010 to December 2013, 276 patients (173 men, median age 75 years) were treated according to the Desio Diabetes Diagram i.v. 140–180. The median time to reach glycaemic target was 4 h (Q1–Q3 2–8) in 128 patients with blood glucose >180 mg/dL and 2 h (Q1–Q3 1–4) in 82 patients with blood glucose <140 mg/dL. Once the target had been reached, insulin infusion was maintained for a median of 38 h (Q1–Q3 24–48) with blood glucose between 140 and 180 mg/dL for 58.3% of the infusion time. Over a total of 11,863 h of infusion, seven blood glucose <70 mg/dL occurred. The Desio Diabetes Diagram i.v. 140–180 protocol was considered easy to use by 93% of nurses.
Conclusions:
The Desio Diabetes Diagram i.v. 140–180 protocol, fully managed by nurses, with insulin and glucose intravenous infusion proved effective, safe and feasible in maintaining blood glucose between 140 and 180 mg/dL in patients with diabetes or hyperglycaemia admitted to the intensive cardiac care unit for acute cardiac events.</description><identifier>ISSN: 2048-8726</identifier><identifier>EISSN: 2048-8734</identifier><identifier>DOI: 10.1177/2048872615574110</identifier><identifier>PMID: 25735300</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Aged ; Aged, 80 and over ; Attitude of Health Personnel ; Coronary Care Units - methods ; Evidence-Based Medicine ; Feasibility Studies ; Female ; Humans ; Hyperglycemia - drug therapy ; Hypoglycemic Agents - administration & dosage ; Infusions, Intravenous ; Insulin - administration & dosage ; Insulin Infusion Systems ; Male ; Nurse's Role ; Surveys and Questionnaires</subject><ispartof>European heart journal. Acute cardiovascular care, 2016-04, Vol.5 (2), p.117-124</ispartof><rights>The European Society of Cardiology 2015</rights><rights>The European Society of Cardiology 2015.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c337t-bac9c9a69a936241a14f7bb639e47ccf1c8c2454ffdf6f6856a4804df8a8bc853</citedby><cites>FETCH-LOGICAL-c337t-bac9c9a69a936241a14f7bb639e47ccf1c8c2454ffdf6f6856a4804df8a8bc853</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/2048872615574110$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/2048872615574110$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25735300$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Avanzini, Fausto</creatorcontrib><creatorcontrib>Marelli, Giuseppe</creatorcontrib><creatorcontrib>Saltafossi, Donata</creatorcontrib><creatorcontrib>Longhi, Chiara</creatorcontrib><creatorcontrib>Carbone, Stefania</creatorcontrib><creatorcontrib>Carlino, Liliana</creatorcontrib><creatorcontrib>Planca, Enrico</creatorcontrib><creatorcontrib>Vilei, Veronica</creatorcontrib><creatorcontrib>Roncaglioni, Maria Carla</creatorcontrib><creatorcontrib>Riva, Emma</creatorcontrib><creatorcontrib>Avanzini, F.</creatorcontrib><creatorcontrib>Balestri, G.</creatorcontrib><creatorcontrib>Bertocchi, P.</creatorcontrib><creatorcontrib>Chiappa, L.</creatorcontrib><creatorcontrib>Corticelli, A.</creatorcontrib><creatorcontrib>Faricelli, S.</creatorcontrib><creatorcontrib>Iacuitti, G.</creatorcontrib><creatorcontrib>Mantovani, G.</creatorcontrib><creatorcontrib>Moro, C.</creatorcontrib><creatorcontrib>Mollichelli, N.</creatorcontrib><creatorcontrib>Planca, E.</creatorcontrib><creatorcontrib>Rogatska, R.</creatorcontrib><creatorcontrib>Saltafossi, D.</creatorcontrib><creatorcontrib>Schiavina, R.</creatorcontrib><creatorcontrib>Tresoldi, S.</creatorcontrib><creatorcontrib>Vandoni, P.</creatorcontrib><creatorcontrib>Amodeo, R.</creatorcontrib><creatorcontrib>Baldo, S.</creatorcontrib><creatorcontrib>Bertazzolo, J.</creatorcontrib><creatorcontrib>Bottan, S.L.</creatorcontrib><creatorcontrib>Busi, G.</creatorcontrib><creatorcontrib>Carbone, S.</creatorcontrib><creatorcontrib>Carlino, L.</creatorcontrib><creatorcontrib>Caspani, M.</creatorcontrib><creatorcontrib>Ciceri, R.</creatorcontrib><creatorcontrib>Ciotta, L.</creatorcontrib><creatorcontrib>Cotza, R.</creatorcontrib><creatorcontrib>D’Amato, D.</creatorcontrib><creatorcontrib>Grassi, C.</creatorcontrib><creatorcontrib>De Ponti, A.</creatorcontrib><creatorcontrib>Di Rocco, E.</creatorcontrib><creatorcontrib>Donè, V.</creatorcontrib><creatorcontrib>Feliciano, F.</creatorcontrib><creatorcontrib>Frigerio, I.</creatorcontrib><creatorcontrib>Gagliardi, A.M.</creatorcontrib><creatorcontrib>Ilardi, M.</creatorcontrib><creatorcontrib>Ledda, A.</creatorcontrib><creatorcontrib>Lippi, B.</creatorcontrib><creatorcontrib>Longhi, C.</creatorcontrib><creatorcontrib>Mamo, R.M.</creatorcontrib><creatorcontrib>Mancuso, M.A.</creatorcontrib><creatorcontrib>Maniscalco, G.</creatorcontrib><creatorcontrib>Palazzo, E.</creatorcontrib><creatorcontrib>Pellegrino, D.</creatorcontrib><creatorcontrib>Pintonello, D.</creatorcontrib><creatorcontrib>Pugliese, U.</creatorcontrib><creatorcontrib>Radaelli, C.</creatorcontrib><creatorcontrib>Stelluti, G.</creatorcontrib><creatorcontrib>Stercoli, M.C.</creatorcontrib><creatorcontrib>Sutera, S.</creatorcontrib><creatorcontrib>Tonelli, L.</creatorcontrib><creatorcontrib>Tullio, F.</creatorcontrib><creatorcontrib>Battaglia, E.</creatorcontrib><creatorcontrib>Maida, A.</creatorcontrib><creatorcontrib>Mandolaro, D.</creatorcontrib><creatorcontrib>Sala, P.</creatorcontrib><creatorcontrib>Stillitano, F.</creatorcontrib><creatorcontrib>Marelli, G.</creatorcontrib><creatorcontrib>Vilei, V.</creatorcontrib><creatorcontrib>Rumi, P.</creatorcontrib><creatorcontrib>Bellato, L.</creatorcontrib><creatorcontrib>Fedeli, M.</creatorcontrib><creatorcontrib>Merlini, A.</creatorcontrib><creatorcontrib>Pinelli, G.</creatorcontrib><creatorcontrib>Colombo, E.</creatorcontrib><creatorcontrib>De Luca, E.</creatorcontrib><creatorcontrib>Galimberti, C.</creatorcontrib><creatorcontrib>Desio Diabetes Diagram (DDD) study group</creatorcontrib><creatorcontrib>on behalf of the Desio Diabetes Diagram (DDD) study group</creatorcontrib><title>Effectiveness, safety and feasibility of an evidence-based insulin infusion protocol targeting moderate glycaemic control in intensive cardiac care units</title><title>European heart journal. Acute cardiovascular care</title><addtitle>Eur Heart J Acute Cardiovasc Care</addtitle><description>Objectives:
To assess the effectiveness, safety and feasibility of the revised, simplified nurse-managed version of our insulin infusion protocol, adapted to the new recommended glycaemic target of 140 to 180 mg/dL (Desio Diabetes Diagram i.v. 140–180).
Methods:
All clinical responses to the Desio Diabetes Diagram i.v. 140–180 in use for 3 years were recorded in patients with diabetes or hyperglycaemia admitted to our intensive cardiac care unit. To assess the feasibility, we asked nurses to complete an ad hoc questionnaire anonymously when the new insulin infusion protocol had been in use for 2 years.
Results:
From December 2010 to December 2013, 276 patients (173 men, median age 75 years) were treated according to the Desio Diabetes Diagram i.v. 140–180. The median time to reach glycaemic target was 4 h (Q1–Q3 2–8) in 128 patients with blood glucose >180 mg/dL and 2 h (Q1–Q3 1–4) in 82 patients with blood glucose <140 mg/dL. Once the target had been reached, insulin infusion was maintained for a median of 38 h (Q1–Q3 24–48) with blood glucose between 140 and 180 mg/dL for 58.3% of the infusion time. Over a total of 11,863 h of infusion, seven blood glucose <70 mg/dL occurred. The Desio Diabetes Diagram i.v. 140–180 protocol was considered easy to use by 93% of nurses.
Conclusions:
The Desio Diabetes Diagram i.v. 140–180 protocol, fully managed by nurses, with insulin and glucose intravenous infusion proved effective, safe and feasible in maintaining blood glucose between 140 and 180 mg/dL in patients with diabetes or hyperglycaemia admitted to the intensive cardiac care unit for acute cardiac events.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Attitude of Health Personnel</subject><subject>Coronary Care Units - methods</subject><subject>Evidence-Based Medicine</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Hyperglycemia - drug therapy</subject><subject>Hypoglycemic Agents - administration & dosage</subject><subject>Infusions, Intravenous</subject><subject>Insulin - administration & dosage</subject><subject>Insulin Infusion Systems</subject><subject>Male</subject><subject>Nurse's Role</subject><subject>Surveys and Questionnaires</subject><issn>2048-8726</issn><issn>2048-8734</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1UU1r3TAQFKUlCWnuORUde6hbyZYl-VhC-gGBXpKzkderh4ItpVo58H5K_m30-tIcCt3LrJaZ2RXD2KUUn6U05ksrlLWm1bLvjZJSvGFnh1FjTafevvatPmUXRPeilhFa2e6Enba96fpOiDP2dO09QgmPGJHoEyfnsey5izP36ChMYQn1nXwdcXwMM0bAZnKEMw-RtiXEin6jkCJ_yKkkSAsvLu-whLjja5oxu4J8t-zB4RqAQ4olV9IfZcFIdTkHl-fg4IDItxgKvWfvvFsIL17wnN19u769-tHc_Pr-8-rrTQNdZ0o9BQYYnB7c0OlWSSeVN9OkuwGVAfASLLSqV97PXntte-2UFWr21tkJbN-ds49H33r97w2pjGsgwGVxEdNGozRV1JtB60oVRyrkRJTRjw85rC7vRynGQybjv5lUyYcX921acX4V_E2gEpojgdwOx_u05Vh_-3_DZz-Rl5Y</recordid><startdate>20160401</startdate><enddate>20160401</enddate><creator>Avanzini, Fausto</creator><creator>Marelli, Giuseppe</creator><creator>Saltafossi, Donata</creator><creator>Longhi, Chiara</creator><creator>Carbone, Stefania</creator><creator>Carlino, Liliana</creator><creator>Planca, Enrico</creator><creator>Vilei, Veronica</creator><creator>Roncaglioni, Maria Carla</creator><creator>Riva, Emma</creator><creator>Avanzini, F.</creator><creator>Balestri, G.</creator><creator>Bertocchi, P.</creator><creator>Chiappa, L.</creator><creator>Corticelli, A.</creator><creator>Faricelli, S.</creator><creator>Iacuitti, G.</creator><creator>Mantovani, G.</creator><creator>Moro, C.</creator><creator>Mollichelli, N.</creator><creator>Planca, E.</creator><creator>Rogatska, R.</creator><creator>Saltafossi, D.</creator><creator>Schiavina, R.</creator><creator>Tresoldi, S.</creator><creator>Vandoni, P.</creator><creator>Amodeo, R.</creator><creator>Baldo, S.</creator><creator>Bertazzolo, J.</creator><creator>Bottan, S.L.</creator><creator>Busi, G.</creator><creator>Carbone, S.</creator><creator>Carlino, L.</creator><creator>Caspani, M.</creator><creator>Ciceri, R.</creator><creator>Ciotta, L.</creator><creator>Cotza, R.</creator><creator>D’Amato, D.</creator><creator>Grassi, C.</creator><creator>De Ponti, A.</creator><creator>Di Rocco, E.</creator><creator>Donè, V.</creator><creator>Feliciano, F.</creator><creator>Frigerio, I.</creator><creator>Gagliardi, A.M.</creator><creator>Ilardi, M.</creator><creator>Ledda, A.</creator><creator>Lippi, B.</creator><creator>Longhi, C.</creator><creator>Mamo, R.M.</creator><creator>Mancuso, M.A.</creator><creator>Maniscalco, G.</creator><creator>Palazzo, E.</creator><creator>Pellegrino, D.</creator><creator>Pintonello, D.</creator><creator>Pugliese, U.</creator><creator>Radaelli, C.</creator><creator>Stelluti, G.</creator><creator>Stercoli, M.C.</creator><creator>Sutera, S.</creator><creator>Tonelli, L.</creator><creator>Tullio, F.</creator><creator>Battaglia, E.</creator><creator>Maida, A.</creator><creator>Mandolaro, D.</creator><creator>Sala, P.</creator><creator>Stillitano, F.</creator><creator>Marelli, G.</creator><creator>Vilei, V.</creator><creator>Rumi, P.</creator><creator>Bellato, L.</creator><creator>Fedeli, M.</creator><creator>Merlini, A.</creator><creator>Pinelli, G.</creator><creator>Colombo, E.</creator><creator>De Luca, E.</creator><creator>Galimberti, C.</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20160401</creationdate><title>Effectiveness, safety and feasibility of an evidence-based insulin infusion protocol targeting moderate glycaemic control in intensive cardiac care units</title><author>Avanzini, Fausto ; Marelli, Giuseppe ; Saltafossi, Donata ; Longhi, Chiara ; Carbone, Stefania ; Carlino, Liliana ; Planca, Enrico ; Vilei, Veronica ; Roncaglioni, Maria Carla ; Riva, Emma ; Avanzini, F. ; Balestri, G. ; Bertocchi, P. ; Chiappa, L. ; Corticelli, A. ; Faricelli, S. ; Iacuitti, G. ; Mantovani, G. ; Moro, C. ; Mollichelli, N. ; Planca, E. ; Rogatska, R. ; Saltafossi, D. ; Schiavina, R. ; Tresoldi, S. ; Vandoni, P. ; Amodeo, R. ; Baldo, S. ; Bertazzolo, J. ; Bottan, S.L. ; Busi, G. ; Carbone, S. ; Carlino, L. ; Caspani, M. ; Ciceri, R. ; Ciotta, L. ; Cotza, R. ; D’Amato, D. ; Grassi, C. ; De Ponti, A. ; Di Rocco, E. ; Donè, V. ; Feliciano, F. ; Frigerio, I. ; Gagliardi, A.M. ; Ilardi, M. ; Ledda, A. ; Lippi, B. ; Longhi, C. ; Mamo, R.M. ; Mancuso, M.A. ; Maniscalco, G. ; Palazzo, E. ; Pellegrino, D. ; Pintonello, D. ; Pugliese, U. ; Radaelli, C. ; Stelluti, G. ; Stercoli, M.C. ; Sutera, S. ; Tonelli, L. ; Tullio, F. ; Battaglia, E. ; Maida, A. ; Mandolaro, D. ; Sala, P. ; Stillitano, F. ; Marelli, G. ; Vilei, V. ; Rumi, P. ; Bellato, L. ; Fedeli, M. ; Merlini, A. ; Pinelli, G. ; Colombo, E. ; De Luca, E. ; Galimberti, C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c337t-bac9c9a69a936241a14f7bb639e47ccf1c8c2454ffdf6f6856a4804df8a8bc853</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Attitude of Health Personnel</topic><topic>Coronary Care Units - methods</topic><topic>Evidence-Based Medicine</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Humans</topic><topic>Hyperglycemia - drug therapy</topic><topic>Hypoglycemic Agents - administration & dosage</topic><topic>Infusions, Intravenous</topic><topic>Insulin - administration & dosage</topic><topic>Insulin Infusion Systems</topic><topic>Male</topic><topic>Nurse's Role</topic><topic>Surveys and Questionnaires</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Avanzini, Fausto</creatorcontrib><creatorcontrib>Marelli, Giuseppe</creatorcontrib><creatorcontrib>Saltafossi, Donata</creatorcontrib><creatorcontrib>Longhi, Chiara</creatorcontrib><creatorcontrib>Carbone, Stefania</creatorcontrib><creatorcontrib>Carlino, Liliana</creatorcontrib><creatorcontrib>Planca, Enrico</creatorcontrib><creatorcontrib>Vilei, Veronica</creatorcontrib><creatorcontrib>Roncaglioni, Maria Carla</creatorcontrib><creatorcontrib>Riva, Emma</creatorcontrib><creatorcontrib>Avanzini, F.</creatorcontrib><creatorcontrib>Balestri, G.</creatorcontrib><creatorcontrib>Bertocchi, P.</creatorcontrib><creatorcontrib>Chiappa, L.</creatorcontrib><creatorcontrib>Corticelli, A.</creatorcontrib><creatorcontrib>Faricelli, S.</creatorcontrib><creatorcontrib>Iacuitti, G.</creatorcontrib><creatorcontrib>Mantovani, G.</creatorcontrib><creatorcontrib>Moro, C.</creatorcontrib><creatorcontrib>Mollichelli, N.</creatorcontrib><creatorcontrib>Planca, E.</creatorcontrib><creatorcontrib>Rogatska, R.</creatorcontrib><creatorcontrib>Saltafossi, D.</creatorcontrib><creatorcontrib>Schiavina, R.</creatorcontrib><creatorcontrib>Tresoldi, S.</creatorcontrib><creatorcontrib>Vandoni, P.</creatorcontrib><creatorcontrib>Amodeo, R.</creatorcontrib><creatorcontrib>Baldo, S.</creatorcontrib><creatorcontrib>Bertazzolo, J.</creatorcontrib><creatorcontrib>Bottan, S.L.</creatorcontrib><creatorcontrib>Busi, G.</creatorcontrib><creatorcontrib>Carbone, S.</creatorcontrib><creatorcontrib>Carlino, L.</creatorcontrib><creatorcontrib>Caspani, M.</creatorcontrib><creatorcontrib>Ciceri, R.</creatorcontrib><creatorcontrib>Ciotta, L.</creatorcontrib><creatorcontrib>Cotza, R.</creatorcontrib><creatorcontrib>D’Amato, D.</creatorcontrib><creatorcontrib>Grassi, C.</creatorcontrib><creatorcontrib>De Ponti, A.</creatorcontrib><creatorcontrib>Di Rocco, E.</creatorcontrib><creatorcontrib>Donè, V.</creatorcontrib><creatorcontrib>Feliciano, F.</creatorcontrib><creatorcontrib>Frigerio, I.</creatorcontrib><creatorcontrib>Gagliardi, A.M.</creatorcontrib><creatorcontrib>Ilardi, M.</creatorcontrib><creatorcontrib>Ledda, A.</creatorcontrib><creatorcontrib>Lippi, B.</creatorcontrib><creatorcontrib>Longhi, C.</creatorcontrib><creatorcontrib>Mamo, R.M.</creatorcontrib><creatorcontrib>Mancuso, M.A.</creatorcontrib><creatorcontrib>Maniscalco, G.</creatorcontrib><creatorcontrib>Palazzo, E.</creatorcontrib><creatorcontrib>Pellegrino, D.</creatorcontrib><creatorcontrib>Pintonello, D.</creatorcontrib><creatorcontrib>Pugliese, U.</creatorcontrib><creatorcontrib>Radaelli, C.</creatorcontrib><creatorcontrib>Stelluti, G.</creatorcontrib><creatorcontrib>Stercoli, M.C.</creatorcontrib><creatorcontrib>Sutera, S.</creatorcontrib><creatorcontrib>Tonelli, L.</creatorcontrib><creatorcontrib>Tullio, F.</creatorcontrib><creatorcontrib>Battaglia, E.</creatorcontrib><creatorcontrib>Maida, A.</creatorcontrib><creatorcontrib>Mandolaro, D.</creatorcontrib><creatorcontrib>Sala, P.</creatorcontrib><creatorcontrib>Stillitano, F.</creatorcontrib><creatorcontrib>Marelli, G.</creatorcontrib><creatorcontrib>Vilei, V.</creatorcontrib><creatorcontrib>Rumi, P.</creatorcontrib><creatorcontrib>Bellato, L.</creatorcontrib><creatorcontrib>Fedeli, M.</creatorcontrib><creatorcontrib>Merlini, A.</creatorcontrib><creatorcontrib>Pinelli, G.</creatorcontrib><creatorcontrib>Colombo, E.</creatorcontrib><creatorcontrib>De Luca, E.</creatorcontrib><creatorcontrib>Galimberti, C.</creatorcontrib><creatorcontrib>Desio Diabetes Diagram (DDD) study group</creatorcontrib><creatorcontrib>on behalf of the Desio Diabetes Diagram (DDD) study group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European heart journal. Acute cardiovascular care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Avanzini, Fausto</au><au>Marelli, Giuseppe</au><au>Saltafossi, Donata</au><au>Longhi, Chiara</au><au>Carbone, Stefania</au><au>Carlino, Liliana</au><au>Planca, Enrico</au><au>Vilei, Veronica</au><au>Roncaglioni, Maria Carla</au><au>Riva, Emma</au><au>Avanzini, F.</au><au>Balestri, G.</au><au>Bertocchi, P.</au><au>Chiappa, L.</au><au>Corticelli, A.</au><au>Faricelli, S.</au><au>Iacuitti, G.</au><au>Mantovani, G.</au><au>Moro, C.</au><au>Mollichelli, N.</au><au>Planca, E.</au><au>Rogatska, R.</au><au>Saltafossi, D.</au><au>Schiavina, R.</au><au>Tresoldi, S.</au><au>Vandoni, P.</au><au>Amodeo, R.</au><au>Baldo, S.</au><au>Bertazzolo, J.</au><au>Bottan, S.L.</au><au>Busi, G.</au><au>Carbone, S.</au><au>Carlino, L.</au><au>Caspani, M.</au><au>Ciceri, R.</au><au>Ciotta, L.</au><au>Cotza, R.</au><au>D’Amato, D.</au><au>Grassi, C.</au><au>De Ponti, A.</au><au>Di Rocco, E.</au><au>Donè, V.</au><au>Feliciano, F.</au><au>Frigerio, I.</au><au>Gagliardi, A.M.</au><au>Ilardi, M.</au><au>Ledda, A.</au><au>Lippi, B.</au><au>Longhi, C.</au><au>Mamo, R.M.</au><au>Mancuso, M.A.</au><au>Maniscalco, G.</au><au>Palazzo, E.</au><au>Pellegrino, D.</au><au>Pintonello, D.</au><au>Pugliese, U.</au><au>Radaelli, C.</au><au>Stelluti, G.</au><au>Stercoli, M.C.</au><au>Sutera, S.</au><au>Tonelli, L.</au><au>Tullio, F.</au><au>Battaglia, E.</au><au>Maida, A.</au><au>Mandolaro, D.</au><au>Sala, P.</au><au>Stillitano, F.</au><au>Marelli, G.</au><au>Vilei, V.</au><au>Rumi, P.</au><au>Bellato, L.</au><au>Fedeli, M.</au><au>Merlini, A.</au><au>Pinelli, G.</au><au>Colombo, E.</au><au>De Luca, E.</au><au>Galimberti, C.</au><aucorp>Desio Diabetes Diagram (DDD) study group</aucorp><aucorp>on behalf of the Desio Diabetes Diagram (DDD) study group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectiveness, safety and feasibility of an evidence-based insulin infusion protocol targeting moderate glycaemic control in intensive cardiac care units</atitle><jtitle>European heart journal. Acute cardiovascular care</jtitle><addtitle>Eur Heart J Acute Cardiovasc Care</addtitle><date>2016-04-01</date><risdate>2016</risdate><volume>5</volume><issue>2</issue><spage>117</spage><epage>124</epage><pages>117-124</pages><issn>2048-8726</issn><eissn>2048-8734</eissn><abstract>Objectives:
To assess the effectiveness, safety and feasibility of the revised, simplified nurse-managed version of our insulin infusion protocol, adapted to the new recommended glycaemic target of 140 to 180 mg/dL (Desio Diabetes Diagram i.v. 140–180).
Methods:
All clinical responses to the Desio Diabetes Diagram i.v. 140–180 in use for 3 years were recorded in patients with diabetes or hyperglycaemia admitted to our intensive cardiac care unit. To assess the feasibility, we asked nurses to complete an ad hoc questionnaire anonymously when the new insulin infusion protocol had been in use for 2 years.
Results:
From December 2010 to December 2013, 276 patients (173 men, median age 75 years) were treated according to the Desio Diabetes Diagram i.v. 140–180. The median time to reach glycaemic target was 4 h (Q1–Q3 2–8) in 128 patients with blood glucose >180 mg/dL and 2 h (Q1–Q3 1–4) in 82 patients with blood glucose <140 mg/dL. Once the target had been reached, insulin infusion was maintained for a median of 38 h (Q1–Q3 24–48) with blood glucose between 140 and 180 mg/dL for 58.3% of the infusion time. Over a total of 11,863 h of infusion, seven blood glucose <70 mg/dL occurred. The Desio Diabetes Diagram i.v. 140–180 protocol was considered easy to use by 93% of nurses.
Conclusions:
The Desio Diabetes Diagram i.v. 140–180 protocol, fully managed by nurses, with insulin and glucose intravenous infusion proved effective, safe and feasible in maintaining blood glucose between 140 and 180 mg/dL in patients with diabetes or hyperglycaemia admitted to the intensive cardiac care unit for acute cardiac events.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>25735300</pmid><doi>10.1177/2048872615574110</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2048-8726 |
| ispartof | European heart journal. Acute cardiovascular care, 2016-04, Vol.5 (2), p.117-124 |
| issn | 2048-8726 2048-8734 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1768557966 |
| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; SAGE Complete |
| subjects | Aged Aged, 80 and over Attitude of Health Personnel Coronary Care Units - methods Evidence-Based Medicine Feasibility Studies Female Humans Hyperglycemia - drug therapy Hypoglycemic Agents - administration & dosage Infusions, Intravenous Insulin - administration & dosage Insulin Infusion Systems Male Nurse's Role Surveys and Questionnaires |
| title | Effectiveness, safety and feasibility of an evidence-based insulin infusion protocol targeting moderate glycaemic control in intensive cardiac care units |
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