Journal article
Strict versus liberal insulin therapy in the cardiac surgery patient: An evidence-based practice development, implementation and evaluation project
Applied nursing research, Vol.39, pp.265-269
02/01/2018
DOI: 10.1016/j.apnr.2017.11.013
PMID: 29422171
Abstract
Background: Hyperglycemia post-cardiac surgery is associated with poor clinical outcomes. Recent studies suggest maintaining liberal glycemic control (< 180 mg/dL) using a continuous insulin infusion (CII) versus strict control achieves optimal outcomes and prevents hypoglycemia.
Purpose: To develop, implement and evaluate a nurse managed liberal CII protocol.
Methods: Retrospective review of 144 strict CII patient records and 147 liberal CII patient records.
Results: Mean blood glucose was 159.8 mg/dL (liberal CII) compared to 143.3 mg/dL (strict CII) (p s 0.001). No surgical site infections occurred in either group. Mean ICU length of stay was 4.5 days (liberal) versus 4.4 days (strict) (p = 0.74). Two 30-day mortalities occurred for the liberal cohort compared to no deaths in the strict group (p = 0.49). Hypoglycemia incidence within 24 h after surgery was 0.1% (liberal) compared to 0.3% (strict) compared to (p = 0.16).
Conclusion: Use of a nurse managed liberal CII resulted in similar outcomes with fewer incidents of hypoglycemia.
Details
- Title: Subtitle
- Strict versus liberal insulin therapy in the cardiac surgery patient: An evidence-based practice development, implementation and evaluation project
- Creators
- Jacqueline M. Gordon - Pennsylvania State UniversityLori S. Lauver - Pennsylvania State UniversityHarleah G. Buck - Pennsylvania State University
- Resource Type
- Journal article
- Publication Details
- Applied nursing research, Vol.39, pp.265-269
- Publisher
- Elsevier
- DOI
- 10.1016/j.apnr.2017.11.013
- PMID
- 29422171
- ISSN
- 0897-1897
- eISSN
- 1532-8201
- Number of pages
- 5
- Language
- English
- Date published
- 02/01/2018
- Academic Unit
- Nursing
- Record Identifier
- 9984370636902771
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