Software might revolutionize glucose monitoring in critically ill patients

Researchers have developed a new computerized system to easily monitor the levels of glucose in the blood of patients in intensive care. A study published today in the open access journal BMC Medical Informatics and Decision Making reports that GRIP, a computer software that assists in the monitoring of glucose levels in critically ill patients, saves nurses time and effort and is more efficient than the paper-based method currently used in many intensive care units (ICUs). Monitoring blood glucose levels is necessary to avoid stress hyperglycemia, an insulin resistance condition that causes glucose levels to go up and has been shown to decrease patient survival. GRIP will be released as open source software.

Mathijs Vogelzang and colleagues from University Medical Center Groningen in the Netherlands implemented GRIP in a 12-bed ICU, for four months. GRIP monitors glucose levels and recommends the appropriate insulin pump rate and the time at which the next blood sample should be taken, and indicates situations in which a physician needs to be notified. In many ICUs, nurses currently monitor glucose levels manually ten to twelve times a day and record their measurements on paper. A total of 179 patients were monitored using GRIP and 22 nurses filled in a questionnaire about the program.

Vogelzang et al.'s results show that 61% of the patients had the right glucose levels more than 75% of the time that they were monitored by GRIP. Only one patient suffered from very low glucose levels, and that was due to human error. Nurses found GRIP easy to use and all agreed that it is an improvement over the paper-based method. Because they only have to control patients six times a day with GRIP, they can monitor more patients and they do not have to call a physician as often as with the current method.

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