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使用计算机化电子胰岛素剂量计算器控制心脏手术患者的手术内高血糖
Ahmed Zaky1,2, Zdenek Novak3, Tinsley Roberson4
1Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. azaky@uabmc.edu.
Scientific reports
|August 29, 2025
概括
在心脏手术患者中,电子胰岛素剂量计算器 (EIC) 有效降低了手术期间的高血糖. 在使用EIC时,该质量改善项目显示血糖水平较低,低血糖也较少.
科学领域:
- 心脏病学
- 内分泌学
- 医疗信息学
背景情况:
- 术后高血糖是手术患者发病率和死亡率上升的已知危险因素.
- 有效的血糖管理至关重要,特别是在复杂的手术中,如涉及心肺绕道手术 (CPB).
研究的目的:
- 评估电子胰岛素剂量计算器 (EIC) 降低手术内高血糖症在接受心脏手术的患者中的有效性.
- 评估EIC实施对血糖水平,低血糖发生率和胰岛素利用的影响.
主要方法:
- 一个质量改进项目在接受CPB的成年心脏手术患者中连续实施了试点和修改EIC.
- 血糖 (BG) 水平,EIC实施率,低血糖发生率和胰岛素剂量在基线,试点EIC和修改EIC阶段进行了比较.
主要成果:
- 与基线相比,试验阶段和修改后的EIC阶段的BG平均水平在CPB期间和程序结束时以及在ICU中明显较低.
- 与基线相比,EIC阶段低血糖的发生率显著降低 (1%).
- 与基线期相比,在EIC实施期间使用的胰岛素较少.
结论:
- 电子胰岛素剂量计算器 (EIC) 是一个有效的工具,用于管理和降低心脏瘤手术患者的手术内高血糖.
- 实施EIC导致血糖控制得到改善,但不增加低血糖的风险,这表明术后血糖管理的方法更安全,更有效.
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