The following is a summary of “Evaluation of Nurse-Driven Management of Hypoglycemia In Critically Ill Patients a step towards explainability,” published in the May 2024 issue of Critical Care by Robinson et al.

Patients in ICU face a high risk of hypoglycemia compared to patients in non-ICU, yet adherence to nurse-driven management protocols remains inconsistent.

Researchers started a retrospective study on the effectiveness of a strictly followed hypoglycemia protocol on management outcomes in the ICU compared to non-ICU controls.

They analyzed patients in ICU aged 18 years or older with at least 1 hypoglycemic event (blood glucose < 70 mg/dL) matched with non-ICU controls by age (within 10 years), sex, and comorbidities. The study compared the time of blood glucose recheck, number of interventions, time to normoglycemia, and number of impulsive hypoglycemic events between the groups.

The result analyzed 140 patients in ICU and 280 non-ICU controls. The median time to blood glucose recheck was 19 minutes for both groups, showing no significant difference. The difference in the mean number of interventions before reaching normoglycemia was statistically significant but not clinically significant (ICU: 1.12; non-ICU: 1.35; P<.001). About 84% of patients in ICU and 86% in non-ICU returned to normoglycemia within 1 hour. The median time to normoglycemia was lower in patients in ICU compared to non-ICU controls (21.5 vs. 26 minutes; P=.01). Approximately 25% of patients in both groups experienced a spontaneous hypoglycemic event.

Investigators concluded that nurse-driven hypoglycemia protocols offered similar benefits in patients of ICU and non-ICU, warranting further investigation into adherence barriers and patient response factors.

Source: aacnjournals.org/ajcconline/article-abstract/33/3/218/32419/Evaluation-of-Nurse-Driven-Management-of