Effect of insulin infusion line on glycaemic variability in a perioperative high dependency unit (HDU): a prospective randomised controlled trial
Background Glucose control is an important issue in post-operative patients. The objective here was to compare two insulin infusion lines by syringe pumps to assess the impact of medical devices on glycaemic variability in surgical patients under intensive insulin therapy. This open, prospective, si...
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doaj-60d7fa8b4c0148faaf0305f10b7d34ca2020-11-24T21:52:00ZengSpringerOpenAnnals of Intensive Care2110-58202017-07-01711910.1186/s13613-017-0298-xEffect of insulin infusion line on glycaemic variability in a perioperative high dependency unit (HDU): a prospective randomised controlled trialStéphanie Genay0Bertrand Décaudin1Sabine Ethgen2Arnaud Alluin3Elodie Babol4Julien Labreuche5Hélène Behal6Marie-Christine Vantyghem7Pascal Odou8Gilles Lebuffe9EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, University of Lille, CHU LilleEA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, University of Lille, CHU LilleEA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, University of Lille, CHU LilleDépartement d’anesthésie-réanimation, CHU LilleDépartement d’anesthésie-réanimation, CHU LilleEA 2694 - Santé publique: épidémiologie et qualité des soins, University of Lille, CHU LilleEA 2694 - Santé publique: épidémiologie et qualité des soins, University of Lille, CHU LilleService d’Endocrinologie et Métabolisme, INSERM U1190, European Genomics Institute for Diabetes EGID, CHU LilleEA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, University of Lille, CHU LilleEA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, University of Lille, CHU LilleBackground Glucose control is an important issue in post-operative patients. The objective here was to compare two insulin infusion lines by syringe pumps to assess the impact of medical devices on glycaemic variability in surgical patients under intensive insulin therapy. This open, prospective, single-centre randomised study was conducted in a fifteen-bed perioperative high dependency unit (HDU) in a university hospital. In total, 172 eligible patients receiving insulin therapy agreed to participate in the study. Subcutaneous continuous glucose monitoring was set up for all patients and an optimised system with a dedicated insulin infusion line for half of the patients. Results Eighty-six patients were infused via the optimised infusion line and 86 patients via the standard infusion line. No significant difference was found according to the glycaemic lability index score [mean difference between groups (95% CI): −0.09 (−0.34; 0.16), p = 0.49 after multiple imputation]. A glucose control monitoring system indicated a trend towards differences in the duration of hypoglycaemia (blood glucose level below 70 mg dl−1 (3.9 mmol l−1) over 1000 h of insulin infusion (9.7 ± 25.0 h in the standard group versus 4.4 ± 14.8 h in the optimised group, p = 0.059) and in the number of patients experiencing at least one hypoglycaemia incident (25.7 vs. 12.9%, p = 0.052). Time in the target range was similar for both groups. Conclusions The use of optimised infusion line with a dedicated insulin infusion line did not reduce glycaemic variability but minimised the incidence of hypoglycaemia events. The choice of the medical devices used to infuse insulin seems important for improving the safety of insulin infusion in perioperative HDU.http://link.springer.com/article/10.1186/s13613-017-0298-xInsulinPerioperative careInfusions, intravenous/instrumentationInfusion pumpsDrug delivery systems/instrumentation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Stéphanie Genay Bertrand Décaudin Sabine Ethgen Arnaud Alluin Elodie Babol Julien Labreuche Hélène Behal Marie-Christine Vantyghem Pascal Odou Gilles Lebuffe |
spellingShingle |
Stéphanie Genay Bertrand Décaudin Sabine Ethgen Arnaud Alluin Elodie Babol Julien Labreuche Hélène Behal Marie-Christine Vantyghem Pascal Odou Gilles Lebuffe Effect of insulin infusion line on glycaemic variability in a perioperative high dependency unit (HDU): a prospective randomised controlled trial Annals of Intensive Care Insulin Perioperative care Infusions, intravenous/instrumentation Infusion pumps Drug delivery systems/instrumentation |
author_facet |
Stéphanie Genay Bertrand Décaudin Sabine Ethgen Arnaud Alluin Elodie Babol Julien Labreuche Hélène Behal Marie-Christine Vantyghem Pascal Odou Gilles Lebuffe |
author_sort |
Stéphanie Genay |
title |
Effect of insulin infusion line on glycaemic variability in a perioperative high dependency unit (HDU): a prospective randomised controlled trial |
title_short |
Effect of insulin infusion line on glycaemic variability in a perioperative high dependency unit (HDU): a prospective randomised controlled trial |
title_full |
Effect of insulin infusion line on glycaemic variability in a perioperative high dependency unit (HDU): a prospective randomised controlled trial |
title_fullStr |
Effect of insulin infusion line on glycaemic variability in a perioperative high dependency unit (HDU): a prospective randomised controlled trial |
title_full_unstemmed |
Effect of insulin infusion line on glycaemic variability in a perioperative high dependency unit (HDU): a prospective randomised controlled trial |
title_sort |
effect of insulin infusion line on glycaemic variability in a perioperative high dependency unit (hdu): a prospective randomised controlled trial |
publisher |
SpringerOpen |
series |
Annals of Intensive Care |
issn |
2110-5820 |
publishDate |
2017-07-01 |
description |
Background Glucose control is an important issue in post-operative patients. The objective here was to compare two insulin infusion lines by syringe pumps to assess the impact of medical devices on glycaemic variability in surgical patients under intensive insulin therapy. This open, prospective, single-centre randomised study was conducted in a fifteen-bed perioperative high dependency unit (HDU) in a university hospital. In total, 172 eligible patients receiving insulin therapy agreed to participate in the study. Subcutaneous continuous glucose monitoring was set up for all patients and an optimised system with a dedicated insulin infusion line for half of the patients. Results Eighty-six patients were infused via the optimised infusion line and 86 patients via the standard infusion line. No significant difference was found according to the glycaemic lability index score [mean difference between groups (95% CI): −0.09 (−0.34; 0.16), p = 0.49 after multiple imputation]. A glucose control monitoring system indicated a trend towards differences in the duration of hypoglycaemia (blood glucose level below 70 mg dl−1 (3.9 mmol l−1) over 1000 h of insulin infusion (9.7 ± 25.0 h in the standard group versus 4.4 ± 14.8 h in the optimised group, p = 0.059) and in the number of patients experiencing at least one hypoglycaemia incident (25.7 vs. 12.9%, p = 0.052). Time in the target range was similar for both groups. Conclusions The use of optimised infusion line with a dedicated insulin infusion line did not reduce glycaemic variability but minimised the incidence of hypoglycaemia events. The choice of the medical devices used to infuse insulin seems important for improving the safety of insulin infusion in perioperative HDU. |
topic |
Insulin Perioperative care Infusions, intravenous/instrumentation Infusion pumps Drug delivery systems/instrumentation |
url |
http://link.springer.com/article/10.1186/s13613-017-0298-x |
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