Yoğun Bakım Hastalarının Glisemi Takibinde Protokol Kullanımının Önemi

Akut kritik ortamlarda, hastaların takibinde standart bir takip veya tedavi yaklaşımının ortaya konması, hastalarda sağ kalıma etki eden çok önemli bir faktördür. Her hasta veya klinik durum için, yaklaşımların standardizasyonu, takip ve tedaviyi yürüten ekibin tüm bireylerinin, aynı yaklaşımı sergilemesini sağlar. Özellikle yoğun bakımda oluşturulan glisemi takip protokolleri ile hastaların glisemi takipleri, yönetilmesi zor olan süreçlerde herhangi bir medikal hata veya gecikme olmasını engelleyebilmektedir. Bu derlemenin amacı, yoğun bakım hastalarında glisemi t akibinde protokol kullanımının önemi hakkında literatüre katkı sağlamaktır.

The Importance of Using Protocols in Monitoring of Glyce mi a of Inte nsive C are Patie nts In an acute critical setting, performing a standard follow-up or treatment approach in patients is a very important factor affecting survival of the patients. Standardization of approaches ensures that all members of the team perform the follow-up and treatment with the same approach for each patient or clinical situation. Especially in the intensive care unit, glycemic follow-up protocols can prevent any medical errors or delays in difficultto-manage processes. The purpose of this review article is to provide literature on the importance of using glycemic management protocols by intensive care unit patients.

PDF

___

Montori VM, Bistrian BR, McMahon MM. Hyperglycemia in acutely ill patients. JAMA ; 288: 2167-9.

Clain J, Ramar K, Surani SR. Glucose control in critical care. World J Diabetes 2015; 6: 90.

Hsu CW. Glycemic control in critically ill patients. World J Diabetes 2012; 1: 31-8.

Krinsley JS. Association between hypergly- cemia and increased hospital mortality in a h e- terogeneous population of critically ILL pati- ents. Mayo Clin Proc 2003; 78: 1471-8.

Capes SE, Hunt D, Malmberg K, Gerstein HC. Stress hyperglycaemia and increased risk of death after myocardial infarction in patients with and without diabetes: Systematic over- view. Lancet 2000; 355: 773-8.

Umpierrez GE, Isaac S, Bazargan N, et al. Hy- perglycemia: an independent marker of in- hospital mortality in patients with undiagnosed diabetes. J Clin Endocrinol Metab 2002; 87: 978

Godinjak A, Iglıca A, Burekovic A, et al. Hy- perglycemia in critically ill patients: manage- ment and prognosis. Med Arch 2015; 69: 157-60.

van den Berg G, Wouters P, Weekers F, et al. intensive insulin therapy in criticaly ill patients. N Engl J Med 2001; 345: 1359-67.

Finney SJ, Zekveld C, Elia A, Evans TW. Glu- cose control and mortality in critically Ill pati- ents. JAMA 2003; 290: 2041-7.

Pittas AG, Siegel R, Lau J. Insulin therapy for critically ILL hospitalized patients: A meta- analysis of randomized controlled trials. Arch Intern Med 2004; 164: 2005-11.

Krinsley JS. Effect of an intensive glucose ma- nagement protocol on the mortality of critically ill adult patients. Mayo Clin Proc 2004; 79: 992-

van den Berghe G, Wilmer A, Milants I, et al. Intensive insulin therapy in mixed medi- cal/surgical intensive care units: benefit versus harm. Diabetes 2006; 55: 3151-9.

Brunkhorst FM, Christoph E, Bloos F, et al. Intensive insulin therapy and pentastarch resu s- citation in severe sepsis. N Engl J Med 2008; : 125-39.

Cryer PE, Davis SN, Shamoon H. Hypoglycemia in diabetes. Diabetes Care 2003; 26: 1902-12.

Seaquist ER, Anderson J, Childs B, et al. Hy- poglycemia and diabetes: a report of a workgroup of the American Diabetes Associa- tion and the Endocrine Society. Diabetes Care ; 3: 1384-95.

The versus conventional glucose control in critically ill patients. N Eng J Med 2009; 360: 1283-97.

Lenhardt R, Akça O. Hyperglycemia in the in- tensive Care. Journal of Turkish Society of In- tensive Care 2014; 12: 67-71.

Arabi YM, Tanaim H, Rishu AH. Hypoglycemia with intensive insulin therapy in critically ill pa- tients: Predisposing factors and association with mortality. Crit Care Med 2009; 37: 2536-44.

The NICE-SUGAR Investigators. Hypoglycemia and risk of death in critically ill patients. N Engl J Med 2012; 367:1108-18.

Egi M, Bellomo R, Stachowski E, et al. Hy- poglycemia and outcome in critically ill patients. Mayo Clin Proc 2010; 85: 217-24.

Taylor BE, Schallom M, Sona CS, et al. Efficacy and safety of an insulin infusion protocol in a surgical ICU. J Am Coll Surg 2006; 202: 1-9.

Wilson M, Weinreb J, Soo Hoo GW. Intensive insulin therapy in critical care a review of 12 protocols. Diabetes Care 2007; 30: 1005-11.

Arabi YM, Dabbagh OC, Tamim HM, et al. In- tensive versus conventional insulin therapy: a randomized controlled trial in medical and su r- gical critically ill patients. Crit Care Med 2008; : 3190-7.

Bagshaw SM, Hoste EAJ, Jacka MJ. Intensive vs conventional blood glucose control in criti- cally ill patients. Can J Anesth 2010; 57: 172-5.

van den Berghe G, Wouters PJ, Weekers F, et al. The leuven algorithm. N Engl J Med 2001; 345: -67.

Yatabe T, Yamazaki R, Kitagawa H, et al. The evaluation of the ability of closed-loop glycemic control device to maintain the blood gluco se concentration in intensive care unit patients. Crit Care Med 2011; 39: 575-8.

Akalın HE. Yoğun bakım ünitelerinde kalite iyileştirme. Yoğun Bakım Dergisi 2001; 1: 69

Akalın HE. Yoğun bakım ünitelerinde hasta güvenliği. Yoğun Bakım Dergisi 2005; 5: 141-6.

Akıncı İÖ. Hiperglisemi ve hipoglisemi. Türk Yoğun Bakım Derneği Dergisi 2008; 6: 68-72.

Meijering S, Corstijens A, Tulleken JE, et al. Towards a feasible algorithm for tight glycaemic control in critically ill patients: A systematic re- view of the literature. Crit Care 2006; 10: 1-7.

Correa TD, Almeida FP, Cavalcanti AB, Pereira A, Silva E. Assessment of nursing perceptions of three insulin protocols for blood glucose control in critically ill patients. Einstein 2012; 10: 347

Goldberg PA, Siegel M, Sherwin RS, et al. Imp- lementation of a safe and effective insulin infu- sion protocol in a medical intensive care unit. Diabetes Care 2004; 27: 461-7.

Khalaila R, Libersky E, Catz D, et al. Nurse led implementation of a safe and effective intrave- nous insulin protocol in a Medical Intensive Ca- re Unit. Critical Care Nurse 2011; 33: 27-35.

Çolak R, Kılıç EK. Yoğun bakım hiperglisemi tedavisi ve sıkı glisemik kontrol. Yoğun bakım Sorunları ve Tedavileri. Şahinoğlu H, Dilek A, Kaya A, Editörler. 3.baskı. İstanbul: Nobel Tıp Kitabevleri Ltd. Şti., 2011: 1444-1448.

Dellinger RR, Levy MM, Rhodes A, et al. Sur- viving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Critical Care Medicine 2013; 41: 9.

Randell R, Mitchhell N, Dowding D, Cullum N, Thompson C. Effects of computerized decision support systems on nursing performance and p a- tient outcomes: A systematic rewiew. J Health Serv Res Policy 2007; 12: 242-9.

ONeill ES, Dulhy NM, Chin E. Modelling novi- ce clinical reasoning for a computerize decision support system. J Adv Nurs 2005; 49: 68-77.

Sucu G, Dicle A, Saka O. Hemşirelikte klinik karar verme, etkileyen etmenler ve karar verme modelleri. Hemşirelikte Eğitim ve Araştırma Dergisi 2012; 9: 52-60.

Anderson JA, Wilson P. Clinical decision sup- port systems in nursing. Comput, Inform, Nurs ; 26: 151-8. Eccles M, McCool E, Steen N, et al. Effect of computerised evidence based guidelines on management of asthma aand angina in adults in primary care. BMJ 2002; 325: 1-7.

Fitzmaurice DA, Hobbs F, Murray ET, Holder RL, Allan TF, Rose PE. Oral anticoagulation management in primary care with the use of computerized decision support and near-patient testing: A randomized controlled trial. Arch In- tern Med 2000; 160: 2343-8.

Im EO, Chee W. Decision support computer program for cancer pain management. Comput Inform Nurs. 2003; 21: 12-21.

Im EO, Chee W. Nurses' acceptance of the decision support computer program for cancer pain management. Comput Inform Nurs 2006; : 95-104.

Olinghouse C. Development of a computerized intravenous insulin application (autocal) at Kai- ser Permanente Northwest, Integrated into Kai- ser Permanente Healthconnect: Impact On Sa- fety And Nursing Workload. Perm J 2012; 16: 70.

Canbolat, Ö. Bilgisayar Destekli İnsülin İnfüz- yon Protokolünün Yoğun Bakim Hastalarinin Glisemik Kontrolü Üzerine Etkisi, 2016, Dokto- ra Tezi, Ankara.