Eficiência da solução de insulina: comparação entre diferentes tempos de manutenção da solução

Indicators for best practices in glycemic control in the intensive care unit

“…The authors observed that there were no alterations or damages to the patients and that they did not present hypoglycemia and the desirable glycemic level was reached in both situations, thus justifying the exchange of solution every 24 hours due to saving the nurses time and decreasing material costs. 15 In relation to the concerns raised by the participants regarding drug interactions and IR EV is corroborated with authors presenting the drugs incompatible with insulin, which, therefore, should not be administered in the same way as the infusion catheter. These drugs include amikacin, atracurium, phenytoin, levofloxacin, piperacillin/sulbactam, sulfamethoxazole/trimetropine, chlorpromazine, diazepam, haloperidol, ondansetron, ampicillin, cefoxitin, gentamicin, midazolam, polymyxin B, hydralazine and ranitidine.…”

Glycemic control in patients receiving insulin critics: integrative review

“…22 The administration of continuous intravenous insulin in the intensive care environment is an efficient system to control blood glucose. Preferably, regular human insulin is used in a solution of 100 units diluted in 100 ml of 0.9% saline solution (1 U / ml).…”

“…In addition, blood glucose variability has been associated with increased risk of severe hypoglycemia, with endothelial dysfunction and consequently, cardiovascular mortality. 22 In daily practice, it persists, often with episodes of hypoglycemia during continuous infusion of insulin, despite monitoring by nursing; consisting of measure for digit-puncture the time of glucose in time, monitor the patient's vital signs, in addition to maintaining a continuous supply of glucose, both oral nutrition, enteral and parenteral, guided by protocols of the units. 22 The monitoring conducted shows that glycemic control with insulin IV had higher rates of hypoglycemia despite allowing to achieve a target goal faster and computerized protocols are effective remedies to prevent hypoglycemic events though expensive and still not available in the Brazilian scenario.…”

Fatores de risco para hipoglicemia em pacientes que usam infusão contínua de insulina endovenosa na unidade de terapia intensiva

“…É notório que a hiperglicemia contribui para a elevação da gravidade da doença 1 . Portanto, a manutenção da normoglicemia está associada a taxas reduzidas de infecções e de falências orgânicas, podendo levar a uma menor mortalidade 3 .…”

“…Níveis glicêmicos elevados alteram também a função imunológica e o controle glicêmico adequado melhora a função de macrófagos/neutrófilos. Por isso, a redução da glicemia pela infusão venosa contínua de insulina passou a ser o tratamento utilizado para esse tipo de paciente 3 .…”