Search results
6 sie 2021 · insulin infusion . Getting started: Hold insulin if K <3.3 mM. Most patients: start insulin at 0.1 U/kg/hr (up to a max of 15 U/hr). For severe acidosis (e.g., bicarbonate <5 mM), consider a 10 unit IV insulin bolus followed by an infusion at 0.2 U/kg/hr. Continue insulin infusion per protocol, until ALL the following criteria are met:
Diabetic ketoacidosis (DKA) is a frequent and potentially life-threatening complication of type 1 diabetes. Though preventable and despite advances in monitoring technologies, insulin therapeutics and insulin delivery systems, the rates of both community and hospital acquired DKA remain largely unchanged. Although mortality today is relatively
IV insulin infusion is recommended for critically ill patients with BG levels >180 mg/dL. The use of insulin infusion protocols standardizes care and improves clinical outcomes. Protocol should include strict BG monitoring and personalized insulin infusion rate titration to achieve and maintain BG targets.
Patients with severe DKA (plasma glucose >250 mg/dL, arterial pH <7.00, serum bicarbonate <10 mEq/L), hypotension, anasarca (severe generalized edema), or associated severe critical illness should be managed with intravenous regular insulin in the ICU using the regimen described above.
Based on the other guidelines, and the indirect evidence from children, the JBDS-IP panel recommended that in adults with DKA the insulin infusion rate should be reduced to 0.05 units/kg/hour when blood glucose falls below 14 mmol/L. Joint British Diabetes Societies for Inpatient Care. The management of diabetic ketoacidosis in adults.
I. Utilizing the DKA INFUSION CALCULATOR tab, administer insulin bolus doses; adjust the insulin infusion and adjust the Dextrose 5% with 0.45% NaCl infusion. Repeat glucose at
a. Calculate Total Daily Dose (TDD) for subcutaneous insulin TDD = Infusion rate/h x 20h b. First dose SQ insulin includes [basal insulin + bridging dose aspart, glulisine, lispro or R] x 1 1. If patient will begin eating give: • Half TDD as basal glargine, detemir* or NPH* Plus • Bridging insulin** @ 10% of basal insulin dose • Stop IV ...
