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Influence of smart real-time electronic alerting on glucose control in critically ill patients
Abstract Purpose Hyperglycemia and hypoglycemia are frequently encountered in critically ill patients and associated with adverse outcomes. We configured a smart glycemia alert (S-GLY alert) with our Intensive Care Information System to decrease the number of hyperglycemic values and increase the pr...
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| Published in: | Journal of critical care 2015-02, Vol.30 (1), p.216.e1-216.e6 |
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| container_end_page | 216.e6 |
| container_issue | 1 |
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| container_title | Journal of critical care |
| container_volume | 30 |
| creator | Colpaert, Kirsten, MD, PhD Oeyen, Sandra, MD Sijnave, Bart, PhD Peleman, Renaat, MD, PhD Benoit, Dominique, MD, PhD Decruyenaere, Johan, MD, PhD |
| description | Abstract Purpose Hyperglycemia and hypoglycemia are frequently encountered in critically ill patients and associated with adverse outcomes. We configured a smart glycemia alert (S-GLY alert) with our Intensive Care Information System to decrease the number of hyperglycemic values and increase the proportion of time within the glucose interval of 80 to 150 mg/dL. Materials and Methods Prospective intervention study in surgical intensive care unit in a tertiary care hospital. An 11-week prealert phase was followed by a 15-week intervention phase where the S-GLY alert was alerting the nurses through the Clinical Notification System of the Intensive Care Information System. Results Overall, 2335 S-GLY alerts were recorded. There were less hyperglycemic values and less persistent hyperglycemic episodes in the alert phase (19.5% vs 26.5% [ P < .001] and 9.9% vs 15.4% [ P < .001], respectively). More time was spent within target glucose interval (82.3% vs 75.0%, P = .009). A lower proportion of patients experienced a new-onset hypoglycemic event (< 70 mg/dL) in the alert phase (9.2% vs 15.2%, P = .016). The Sequential Organ Failure Assessment score was significantly reduced (5.2 vs 4.2, P < .001). Conclusions The implementation of a real-time smart electronic glycemia alert resulted in significantly less episodes of persistent hyperglycemia and a higher proportion of time with normoglycemia, while decreasing the number of hypoglycemic events. |
| doi_str_mv | 10.1016/j.jcrc.2014.07.030 |
| format | article |
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We configured a smart glycemia alert (S-GLY alert) with our Intensive Care Information System to decrease the number of hyperglycemic values and increase the proportion of time within the glucose interval of 80 to 150 mg/dL. Materials and Methods Prospective intervention study in surgical intensive care unit in a tertiary care hospital. An 11-week prealert phase was followed by a 15-week intervention phase where the S-GLY alert was alerting the nurses through the Clinical Notification System of the Intensive Care Information System. Results Overall, 2335 S-GLY alerts were recorded. There were less hyperglycemic values and less persistent hyperglycemic episodes in the alert phase (19.5% vs 26.5% [ P < .001] and 9.9% vs 15.4% [ P < .001], respectively). More time was spent within target glucose interval (82.3% vs 75.0%, P = .009). A lower proportion of patients experienced a new-onset hypoglycemic event (< 70 mg/dL) in the alert phase (9.2% vs 15.2%, P = .016). The Sequential Organ Failure Assessment score was significantly reduced (5.2 vs 4.2, P < .001). Conclusions The implementation of a real-time smart electronic glycemia alert resulted in significantly less episodes of persistent hyperglycemia and a higher proportion of time with normoglycemia, while decreasing the number of hypoglycemic events.</description><identifier>ISSN: 0883-9441</identifier><identifier>EISSN: 1557-8615</identifier><identifier>DOI: 10.1016/j.jcrc.2014.07.030</identifier><identifier>PMID: 25194590</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Blood Glucose - analysis ; Clinical Alarms - statistics & numerical data ; Clinical decisions support systems ; Computer systems ; Controlled Before-After Studies - methods ; Critical Care ; Critical Illness ; Female ; Glucose ; Glucose control ; Health information technology ; Homeostasis ; Hospital Information Systems ; Humans ; Hyperglycemia ; Hyperglycemia - blood ; Hyperglycemia - prevention & control ; Hypoglycemia ; Hypoglycemia - blood ; Hypoglycemia - prevention & control ; Hypoglycemic Agents ; Insulin ; Intensive care unit ; Intensive Care Units ; Male ; Middle Aged ; Mortality ; Organ Dysfunction Scores ; Prospective Studies</subject><ispartof>Journal of critical care, 2015-02, Vol.30 (1), p.216.e1-216.e6</ispartof><rights>Elsevier Inc.</rights><rights>2014 Elsevier Inc.</rights><rights>Copyright © 2014 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Feb 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c612t-18d67d75dcc4cd991612f6099a5f96668127405de3f28e547a067d311f5834843</citedby><cites>FETCH-LOGICAL-c612t-18d67d75dcc4cd991612f6099a5f96668127405de3f28e547a067d311f5834843</cites><orcidid>0000-0002-6254-3065</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25194590$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Colpaert, Kirsten, MD, PhD</creatorcontrib><creatorcontrib>Oeyen, Sandra, MD</creatorcontrib><creatorcontrib>Sijnave, Bart, PhD</creatorcontrib><creatorcontrib>Peleman, Renaat, MD, PhD</creatorcontrib><creatorcontrib>Benoit, Dominique, MD, PhD</creatorcontrib><creatorcontrib>Decruyenaere, Johan, MD, PhD</creatorcontrib><title>Influence of smart real-time electronic alerting on glucose control in critically ill patients</title><title>Journal of critical care</title><addtitle>J Crit Care</addtitle><description>Abstract Purpose Hyperglycemia and hypoglycemia are frequently encountered in critically ill patients and associated with adverse outcomes. We configured a smart glycemia alert (S-GLY alert) with our Intensive Care Information System to decrease the number of hyperglycemic values and increase the proportion of time within the glucose interval of 80 to 150 mg/dL. Materials and Methods Prospective intervention study in surgical intensive care unit in a tertiary care hospital. An 11-week prealert phase was followed by a 15-week intervention phase where the S-GLY alert was alerting the nurses through the Clinical Notification System of the Intensive Care Information System. Results Overall, 2335 S-GLY alerts were recorded. There were less hyperglycemic values and less persistent hyperglycemic episodes in the alert phase (19.5% vs 26.5% [ P < .001] and 9.9% vs 15.4% [ P < .001], respectively). More time was spent within target glucose interval (82.3% vs 75.0%, P = .009). A lower proportion of patients experienced a new-onset hypoglycemic event (< 70 mg/dL) in the alert phase (9.2% vs 15.2%, P = .016). The Sequential Organ Failure Assessment score was significantly reduced (5.2 vs 4.2, P < .001). Conclusions The implementation of a real-time smart electronic glycemia alert resulted in significantly less episodes of persistent hyperglycemia and a higher proportion of time with normoglycemia, while decreasing the number of hypoglycemic events.</description><subject>Aged</subject><subject>Blood Glucose - analysis</subject><subject>Clinical Alarms - statistics & numerical data</subject><subject>Clinical decisions support systems</subject><subject>Computer systems</subject><subject>Controlled Before-After Studies - methods</subject><subject>Critical Care</subject><subject>Critical Illness</subject><subject>Female</subject><subject>Glucose</subject><subject>Glucose control</subject><subject>Health information technology</subject><subject>Homeostasis</subject><subject>Hospital Information Systems</subject><subject>Humans</subject><subject>Hyperglycemia</subject><subject>Hyperglycemia - blood</subject><subject>Hyperglycemia - prevention & control</subject><subject>Hypoglycemia</subject><subject>Hypoglycemia - blood</subject><subject>Hypoglycemia - prevention & control</subject><subject>Hypoglycemic Agents</subject><subject>Insulin</subject><subject>Intensive care unit</subject><subject>Intensive Care Units</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Organ Dysfunction Scores</subject><subject>Prospective Studies</subject><issn>0883-9441</issn><issn>1557-8615</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNqNkk2LFDEQhoMo7rj6BzxIwIuXblOdj06DCLLourDgQb0a2nT1kjaTjElamH9vmlld2IN4CiRPvaHqKUKeA2uBgXq9tItNtu0YiJb1LePsAdmBlH2jFciHZMe05s0gBJyRJzkvjEHPuXxMzjoJg5AD25FvV2H2KwaLNM4078dUaMLRN8XtkaJHW1IMztLRYyou3NAY6I1fbcxIbQz11VMXqE2uODt6f6TOe3oYi8NQ8lPyaB59xme35zn5-uH9l4uPzfWny6uLd9eNVdCVBvSk-qmXk7XCTsMA9XZWbBhGOQ9KKQ1dL5ickM-dRin6kVWeA8xSc6EFPyevTrmHFH-umIvZu2zR-zFgXLMBpevEpOj0f6C8l1LoASr68h66xDWF2shGSaa2yEp1J8qmmHPC2RySq4M8GmBmE2UWs4kymyjDelNF1aIXt9Hr9z1Of0v-mKnAmxOAdWy_HCaTrds8TS5VKWaK7t_5b--VW-_CZugHHjHf9WFyZ5j5vK3KtikgGONQ__8NapK3LQ</recordid><startdate>20150201</startdate><enddate>20150201</enddate><creator>Colpaert, Kirsten, MD, PhD</creator><creator>Oeyen, Sandra, MD</creator><creator>Sijnave, Bart, PhD</creator><creator>Peleman, Renaat, MD, PhD</creator><creator>Benoit, Dominique, MD, PhD</creator><creator>Decruyenaere, Johan, MD, PhD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6254-3065</orcidid></search><sort><creationdate>20150201</creationdate><title>Influence of smart real-time electronic alerting on glucose control in critically ill patients</title><author>Colpaert, Kirsten, MD, PhD ; Oeyen, Sandra, MD ; Sijnave, Bart, PhD ; Peleman, Renaat, MD, PhD ; Benoit, Dominique, MD, PhD ; Decruyenaere, Johan, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c612t-18d67d75dcc4cd991612f6099a5f96668127405de3f28e547a067d311f5834843</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Blood Glucose - 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Academic</collection><jtitle>Journal of critical care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Colpaert, Kirsten, MD, PhD</au><au>Oeyen, Sandra, MD</au><au>Sijnave, Bart, PhD</au><au>Peleman, Renaat, MD, PhD</au><au>Benoit, Dominique, MD, PhD</au><au>Decruyenaere, Johan, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Influence of smart real-time electronic alerting on glucose control in critically ill patients</atitle><jtitle>Journal of critical care</jtitle><addtitle>J Crit Care</addtitle><date>2015-02-01</date><risdate>2015</risdate><volume>30</volume><issue>1</issue><spage>216.e1</spage><epage>216.e6</epage><pages>216.e1-216.e6</pages><issn>0883-9441</issn><eissn>1557-8615</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><notes>ObjectType-Article-2</notes><notes>ObjectType-Feature-1</notes><abstract>Abstract Purpose Hyperglycemia and hypoglycemia are frequently encountered in critically ill patients and associated with adverse outcomes. We configured a smart glycemia alert (S-GLY alert) with our Intensive Care Information System to decrease the number of hyperglycemic values and increase the proportion of time within the glucose interval of 80 to 150 mg/dL. Materials and Methods Prospective intervention study in surgical intensive care unit in a tertiary care hospital. An 11-week prealert phase was followed by a 15-week intervention phase where the S-GLY alert was alerting the nurses through the Clinical Notification System of the Intensive Care Information System. Results Overall, 2335 S-GLY alerts were recorded. There were less hyperglycemic values and less persistent hyperglycemic episodes in the alert phase (19.5% vs 26.5% [ P < .001] and 9.9% vs 15.4% [ P < .001], respectively). More time was spent within target glucose interval (82.3% vs 75.0%, P = .009). A lower proportion of patients experienced a new-onset hypoglycemic event (< 70 mg/dL) in the alert phase (9.2% vs 15.2%, P = .016). The Sequential Organ Failure Assessment score was significantly reduced (5.2 vs 4.2, P < .001). Conclusions The implementation of a real-time smart electronic glycemia alert resulted in significantly less episodes of persistent hyperglycemia and a higher proportion of time with normoglycemia, while decreasing the number of hypoglycemic events.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25194590</pmid><doi>10.1016/j.jcrc.2014.07.030</doi><orcidid>https://orcid.org/0000-0002-6254-3065</orcidid></addata></record> |
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| subjects | Aged Blood Glucose - analysis Clinical Alarms - statistics & numerical data Clinical decisions support systems Computer systems Controlled Before-After Studies - methods Critical Care Critical Illness Female Glucose Glucose control Health information technology Homeostasis Hospital Information Systems Humans Hyperglycemia Hyperglycemia - blood Hyperglycemia - prevention & control Hypoglycemia Hypoglycemia - blood Hypoglycemia - prevention & control Hypoglycemic Agents Insulin Intensive care unit Intensive Care Units Male Middle Aged Mortality Organ Dysfunction Scores Prospective Studies |
| title | Influence of smart real-time electronic alerting on glucose control in critically ill patients |
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