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2019, Number 3

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Rev Cuba Enf 2019; 35 (3)

Hypoglycemia and associated risk factors during continuous insulin administration in critically-ill patients

de Azeredo GRM, Vianna AK, Chaves SSP

Language: Portugu?s
References: 28
Page: 1-17
PDF size: 205.74 Kb.


ABSTRACT

Introduction: Hypoglycemia is the most important adverse effect in patients undergoing intravenous insulin therapy in the intensive care unit, due to its difficult control by health professionals, also being associated with other clinical and pathological risk factors.
Objective: To identify in the literature the risk factors for hypoglycemia during the continuous administration of intravenous insulin.
Methods: Integrative review study of the literature. Data collection was carried out by accessing the databases belonging to the Virtual Health Library (VHL), LILACS, MEDLINE, BDENF, and PUBMED, during the period from March to April 2017, which resulted in the selection of 11 studies after the review process.
Conclusion: Risk factors for hypoglycemia during continuous insulin infusion are rigorous glycemic objective, inadequate or discontinued nutritional support, diabetes, organic failure, acute and chronic renal failure, hemodialysis, lack of standardization of the blood glucose measurement pathway, sepsis, vasoactive drugs, delays in blood glucose measurements, inadequate adjustments in the venous insulin protocol, 2-4h insulin verification intervals, influence of glycosylated hemoglobin (HbA1c), liver disease, and difficulties in application and continuity of glycemic surveillance protocols and infusions. Thus, professionals who are directly involved with the aforementioned therapy and with the care for the assisted patient can define behaviors that minimize the occurrence of hypoglycemia and deaths.


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