| 내과 중환자실 환자의 혈당조절 프로토콜 적용 및 효과 |
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김은성, 최스미, 김영삼 |
1세브란스병원 간호부
2서울대학교 간호대학.서울대학교 간호과학연구소
3연세대학교 의과대학 호흡기내과 |
| Application and Effects of a Blood Glucose Control Protocol for Medical Intensive Care Unit Patients |
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Eun Sung Kim, Smi Choi-Kwon, Young Sam Kim |
1Division of Nursing, Severance Hospital
2College of Nursing, Seoul National University, The Research Institute of Nursing Science
3Pulmonology, College of Medicine, Yonsei University |
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| Abstract |
Purpose
The purpose of this study was to examine the effect of a blood glucose control protocol for medical intensive care unit (ICU) patients.
Methods
The subjects were recruited from medical ICU adult patients whose blood glucose levels exceeded 200 mg/dL in two consecutive tests. The experimental group (n=62) received the modified Yale (MY) insulin protocol, whereas the control group (n=64) was treated with the conventional insulin therapy methods.
Results
In the experimental group, the mean blood glucose levels (p<.001) and the time to reach the target range of glucose (p<.001) decreased significantly while the incidence rates of a target range of glucose of 100-140 mg/dL (p<.001) increased significantly as compared to the control group. However, no statistically significant differences were found in the incidence of hypoglycemia(p=.644), or the number of glucose tests (p=.236) between the groups. The length of stays in the ICU (p=.001), ventilator care days (p=.038), and the Sequential Organ Failure Assessment (SOFA) score (p=.029) in the experimental group were significantly lower than those of the control group.
Conclusion
Application of the protocol was effective in improving the state of blood glucose control in medical ICU patients. Therefore, this protocol is expected to be used as a part of nursing intervention in critical care nursing. |
| Key Words:
Critical care, Clinical protocol, Hyperglycemia, Insulin, Clinical markers |
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