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A comparison of two insulin infusion protocols in the medical intensive care unit by continuous glucose monitoring

Overview of attention for article published in Annals of Intensive Care, November 2016
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41 Mendeley
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Title
A comparison of two insulin infusion protocols in the medical intensive care unit by continuous glucose monitoring
Published in
Annals of Intensive Care, November 2016
DOI 10.1186/s13613-016-0214-9
Pubmed ID
Authors

Christophe E. M. Block, Peter Rogiers, Philippe G. Jorens, Tom Schepens, Cosimo Scuffi, Luc F. Gaal, Christophe E. M. De Block, Luc F. Van Gaal

Abstract

Achieving good glycemic control in intensive care units (ICU) requires a safe and efficient insulin infusion protocol (IIP). We aimed to compare the clinical performance of two IIPs (Leuven versus modified Yale protocol) in patients admitted to medical ICU, by using continuous glucose monitoring (CGM). This is a pooled data analysis of two published prospective randomized controlled trials. CGM monitoring was performed in 57 MICU patients (age 64 ± 12 years, APACHE-II score 28 ± 7, non-diabetic/diabetic: 36/21). The main outcome measures were percentage of time in normoglycemia (80-110 mg/dl) and in hypoglycemia (<60 mg/dl), and glycemic variability (standard deviation, coefficient of variation, mean amplitude of glucose excursions, mean of daily differences). Twenty-two subjects were treated using the Leuven protocol and 35 by the Yale protocol; >63,000 CGM measurements were available. The percentage of time in normoglycemia (80-110 mg/dl) was higher (37 ± 15 vs. 26 ± 11%, p = 0.001) and percentage of time spent in hypoglycemia was lower (0[0-2] vs. 5[1-8]%, p = 0.001) in the Yale group. Median glycemia did not differ between groups (118[108-128] vs. 128[106-154] mg/dl). Glycemic variability was less pronounced in the Yale group (median SD 28[21-37] vs. 47[31-71] mg/dl, p = 0.001; CV 23[19-31] vs. 36[26-50]%, p = 0.001; MODD 35[26-41] vs. 60[33-94] mg/dl, p = 0.001). However, logistic regression could not identify type of IIP, diabetes status, age, BMI, or APACHE-II score as independent parameters for strict glucose control. The Yale protocol provided better average glycemia, more time spent in normoglycemia, less time in hypoglycemia, and less glycemic variability than the Leuven protocol, but was not independently associated with strict glycemic control.

Twitter Demographics

The data shown below were collected from the profiles of 3 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 41 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 41 100%

Demographic breakdown

Readers by professional status Count As %
Other 5 12%
Student > Postgraduate 5 12%
Researcher 5 12%
Student > Master 5 12%
Student > Ph. D. Student 5 12%
Other 9 22%
Unknown 7 17%
Readers by discipline Count As %
Medicine and Dentistry 22 54%
Nursing and Health Professions 6 15%
Computer Science 1 2%
Environmental Science 1 2%
Pharmacology, Toxicology and Pharmaceutical Science 1 2%
Other 4 10%
Unknown 6 15%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 07 February 2017.
All research outputs
#7,339,490
of 12,726,035 outputs
Outputs from Annals of Intensive Care
#331
of 531 outputs
Outputs of similar age
#172,637
of 371,266 outputs
Outputs of similar age from Annals of Intensive Care
#36
of 73 outputs
Altmetric has tracked 12,726,035 research outputs across all sources so far. This one is in the 40th percentile – i.e., 40% of other outputs scored the same or lower than it.
So far Altmetric has tracked 531 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.3. This one is in the 32nd percentile – i.e., 32% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 371,266 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 50% of its contemporaries.
We're also able to compare this research output to 73 others from the same source and published within six weeks on either side of this one. This one is in the 38th percentile – i.e., 38% of its contemporaries scored the same or lower than it.