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Safety and efficacy of transitioning from intravenous to subcutaneous insulin in critically ill patients.
Alshaya, Abdulrahman I; DeGrado, Jeremy R; Lupi, Kenneth E; Szumita, Paul M.
Afiliação
  • Alshaya AI; Department of Pharmacy Services, Brigham and Women's Hospital, Boston, MA, USA. alshayaab@gmail.com.
  • DeGrado JR; Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia. alshayaab@gmail.com.
  • Lupi KE; Department of Pharmaceutical Care Services, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia. alshayaab@gmail.com.
  • Szumita PM; King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia. alshayaab@gmail.com.
Int J Clin Pharm ; 44(1): 146-152, 2022 Feb.
Article em En | MEDLINE | ID: mdl-34499290
ABSTRACT
Background Intravenous (IV) insulin is commonly used for the management of hyperglycemia in critically ill patients. However, an assessment of real-world practices for the transition process from IV to Subcutaneous (SC) is lacking. Objective The objective of this study was to describe the real-world practice during insulin transition from IV to SC in intensive care unit (ICU) patients. Setting ICUs at a tertiary medical center. Methods This was a retrospective cohort study. Data were obtained from electronic medical records for all ICU patients for whom insulin infusions were ordered between Nov 2017-2018. Adult ICU patients were included if they were transitioned to a SC insulin regimen after spending at least 6 h on IV insulin infusion. Data collected include blood glucose readings, transition percentage, and the type of insulin regimen used after transition. Main outcome measure Assessment of the transition percentage and dysglycemic events during the insulin transition process from IV to SC. Results Two hundred patients with 4702 blood glucose checks were included. Of the included patients, 65% (130/200) were transitioned to a basal insulin-containing regimen. The median transition percentage in those patients was 45% [IQR 28 - 69]. In the overall cohort, the number of patients who developed moderate and severe hypoglycemia was significantly higher prior to transition, while hyperglycemia was significantly higher after insulin transition. Conclusion We observed that patients were converted to SC therapy using a lower transition percentage than previously described. More data are needed to optimize the transition process in critically ill patients.
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Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 1_ASSA2030 Base de dados: MEDLINE Assunto principal: Hiperglicemia / Hipoglicemia Tipo de estudo: Diagnostic_studies / Observational_studies Limite: Adult / Humans Idioma: En Revista: Int J Clin Pharm Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 1_ASSA2030 Base de dados: MEDLINE Assunto principal: Hiperglicemia / Hipoglicemia Tipo de estudo: Diagnostic_studies / Observational_studies Limite: Adult / Humans Idioma: En Revista: Int J Clin Pharm Ano de publicação: 2022 Tipo de documento: Article