Table 1

Summary of published computer-assisted glucose regulation protocols, designed for critically ill patients

Reference

N

Patient type

APACHE II

Target range (mmol/L)

Performance

Hypoglycaemia^a

Measurements per patient per day

Boord et al. [21]

204

Surgical ICU

?

4.4 to 6.1

49% of time in range

0.2% <2.2 mmol/L

~18 (12 to 24)^b

Cordingley et al. [22]

16

Mixed ICU

16.6

4.4 to 6.1

63% of time in range

0 <2.2 mmol/L

10.9

Davidson et al. [23]

5,808

General medical and surgical floors

?

Variable

'Stable glucose'

0.6% <2.8 mmol/L

~18 (12 to 24)^b

Dortch et al. [24]

243

Trauma ICU

ISS 27.5

4.4 to 6.1

42% of measurements in range

0.2% <2.2 mmol/L

10.7

Hermayer et al. [25]

66

CABG

?

4.4 to 6.7

Mean BG 6.4 mmol/L

0.10% <2.2 mmol/L

16.2^c

Horovorka et al. [26]

30

Cardiac surgery

?

4.4 to 6.1

60% of time in range

0 <2.9 mmol/L

16

Juneja et al. [27]

2,398

Mixed ICU

?

4.4 to 6.1

61% of measurements in range

0.4% <2.8 mmol/L

~18 (12 to 24)^b

Laha et al. [28]

661

Mixed ICU

16

4.5 to 7.2

95% of measurements in the range 3.7 to 12.1 mmol/L

1.7% of patients with a single episode <2.2 mmol/L

~12 (6 to 24)^d

Meyenaar et al. [29]

179

Mixed ICU

13

4.5 to 7.5

53% of time in range

0.05% <2.2 mmol/L

3.4

Morris et al. [30]

775

Mixed ICU

21.8

4.4 to 6.1

42% of measurements in range

0.33% <2.2 mmol/L

~12 (6 to 24)^d

NICE-SUGAR [13]:

3,054

Mixed ICU

21.1

4.5 to 6.0

Mean time-weighted BG

6.8% <2.2 mmol/L

~12 (6 to 24)^d

intensive control

6.4 mmol/L

NICE-SUGAR [13]: conventional control

3,050

Mixed ICU

21.1

8.0 to 10.0

Mean time-weighted BG 8.0 mmol/L

0.5% <2.2 mmol/L

~12 (6 to 24)^d

Pachler et al. [31]

25

Medical ICU

26.6

4.4 to 6.1

HGI = 0.4 mmol/L

1 episode <2.2 mmol/L

12.3

Plank et al. [32]

30

Cardiac surgery

11.4

4.4 to 6.1

52% of time in range

0 <2.2 mmol/L

24

Rood et al. [33]

66

Mixed ICU

19.5

4.0 to 7.0

54% of time in range

0.09% of time <2.5 mmol/L

9.9^c

Saager et al. [34]

20

Cardiac surgery

?

5.0 to 8.3

84% of time in range

5 episodes <3.3 mmol/L

24

Shulman et al. [35]

50

Mixed ICU

23

4.4 to 6.1

23% of time in range

0.04% of time <2.2 mmol/L

12.7

Thomas et al. [36]

603

Mixed ICU

14.4

5.4 to 7.1

85% of measurements <8 mmol/L

19 episodes

~12 (6 to 24)^d

Toschlog et al. [37]

128

Trauma

ISS 24.5

4.4 to 7.2

Mean BG 6.4 mmol/L

32% of patients with a single episode <2.8 mmol/L

?

Vogelzang et al. [38]

2,800

Mixed ICU

14

4.0 to 7.5

67% of time in range

0.04% <2.2 mmol/L

5.9

^aHypoglycaemia is represented as the proportion of all measurements, unless otherwise specified. ^bNo exact data, but protocol has 'hourly to two-hourly measurements'. ^c Calculated from number of measurements and length of stay. ^dNo exact data, but protocol has 'hourly to four-hourly measurements'. APACHE, Acute Physiology and Chronic Health Evaluation II; BG, blood glucose; CABG, coronary artery bypass grafting; HGI, hyperglycaemic index; ISS, Injury Severity Score; NICE-SUGAR, The Normoglycaemia in Intensive Care Evaluation - Survival Using Algorithm Regulation.

Hoekstra et al. Critical Care 2009 13:223   doi:10.1186/cc8023