Infusão contínua de insulina e controle glicêmico em pacientes sépticos: implicações para a enfermagem em terapia intensiva
Ano de defesa: | 2012 |
---|---|
Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | , |
Tipo de documento: | Dissertação |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Universidade do Estado do Rio de Janeiro
|
Programa de Pós-Graduação: |
Programa de Pós-Graduação em Enfermagem
|
Departamento: |
Centro Biomédico::Faculdade de Enfermagem
|
País: |
BR
|
Palavras-chave em Português: | |
Palavras-chave em Inglês: | |
Área do conhecimento CNPq: | |
Link de acesso: | http://www.bdtd.uerj.br/handle/1/11382 |
Resumo: | This study aims to get the glycemic control result from the insulin continuous infusion (ICI) in septic patients in intensive care. The objectives were to determine the hypoglycemia incidence in patients from two Intensive Care Units (ICU) who received ICI and its relation to the target range values for each protocol, and discuss the implications for nursing practice related to hypoglycemia incidence. It is a bi-centric and retrospective cross-sectional study with data collection technique, by analyzing the records and their quantitative assessment. It was developed in two ICUs, one oncology hospital belonging to Union and another to state of Rio de Janeiro. Glycemic measures from septic patients who used ICI in 2010 in both ICUs were collected to data, yielding two thousand, two hundred and thirteen measured in twenty-nine patients (11.88%) from ICU 1, and nine hundred and twenty-three measures in twenty (9.85%) patients from ICU 2. Hypoglycemia records were divided into two categories, measures with values defined by the adopted protocol and measures with values less than 50mg/dL, characterized as severe hypoglycemia by the Institute for Healthcare Improvement. In both categories, it was necessary to intervene, administering hypertonic glucose of 50%. Sixteen patients from ICU 1 had hypoglycemia, four (25%) measuring between 50 and 60mg/dL and twelve (75%) with measures less than 50mg/dL. Thirteen patients from ICU 2 had hypoglycemia, ten (76.92%) measuring between 50 and 80mg/dL and three (23.08%) with measures less than 50mg/dL. For the incidence calculation, the total hypoglycemia episodes were considered independently of category. Comparing the two ICUs, global incidence of hypoglycemia was found in ICU 1 almost five times higher (22.60:4.54). In ICU 1, from fifty hypoglycemia episodes, twenty records were lower than 50mg/dL; in ICU 2, from forty-two hypoglycemia episodes, three records were lower than 50mg/dL. Severe hypoglycaemia in ICU 1 was 1.5 times smaller than the hypoglycemia by protocol; in ICU 2, severe hypoglycaemia was thirteen times smaller than the hypoglycemia by protocol. In ICU 1, from two thousand, two hundred and thirteen measurements, three hundred and seventy-five glucose measurements were below the target range. Of these measures, fifty were characterized as hypoglycemia (375:50). From seven or eight measures below the target range, one was hypoglycemia. In the ICU 2, from nine hundred and twenty-three measurements, two hundred and twenty-three measurements were below the target. From them, forty-two measures were hypoglycaemia (223:42). Therefore, for every five measures below the range, one was hypoglycemia. Considering that ICI in septic patients may contribute to better results, the nursing staff must be capable of making an effective glycemic control with less risk of hypoglycemia. Subsidizing the team with knowledge about the factors predisposing to hypoglycemia, as well as increase the nursing care level, provides indeed to reduce incidence of serious adverse events. |
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Silva, Lolita Dopico dahttp://lattes.cnpq.br/5489255293217583Silva, Roberto Carlos Lyra dahttp://lattes.cnpq.br/3110045515852703Menezes, Maria de Fátima Batalha dehttp://lattes.cnpq.br/7149800876837659http://lattes.cnpq.br/6243108485236992Santos, Manassés Moura dos2021-01-06T14:34:51Z2015-07-142012-02-16SANTOS, Manassés Moura dos. Infusão contínua de insulina e controle glicêmico em pacientes sépticos: implicações para a enfermagem em terapia intensiva. 2012. 121 f. Dissertação (Mestrado em Enfermagem) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2012.http://www.bdtd.uerj.br/handle/1/11382This study aims to get the glycemic control result from the insulin continuous infusion (ICI) in septic patients in intensive care. The objectives were to determine the hypoglycemia incidence in patients from two Intensive Care Units (ICU) who received ICI and its relation to the target range values for each protocol, and discuss the implications for nursing practice related to hypoglycemia incidence. It is a bi-centric and retrospective cross-sectional study with data collection technique, by analyzing the records and their quantitative assessment. It was developed in two ICUs, one oncology hospital belonging to Union and another to state of Rio de Janeiro. Glycemic measures from septic patients who used ICI in 2010 in both ICUs were collected to data, yielding two thousand, two hundred and thirteen measured in twenty-nine patients (11.88%) from ICU 1, and nine hundred and twenty-three measures in twenty (9.85%) patients from ICU 2. Hypoglycemia records were divided into two categories, measures with values defined by the adopted protocol and measures with values less than 50mg/dL, characterized as severe hypoglycemia by the Institute for Healthcare Improvement. In both categories, it was necessary to intervene, administering hypertonic glucose of 50%. Sixteen patients from ICU 1 had hypoglycemia, four (25%) measuring between 50 and 60mg/dL and twelve (75%) with measures less than 50mg/dL. Thirteen patients from ICU 2 had hypoglycemia, ten (76.92%) measuring between 50 and 80mg/dL and three (23.08%) with measures less than 50mg/dL. For the incidence calculation, the total hypoglycemia episodes were considered independently of category. Comparing the two ICUs, global incidence of hypoglycemia was found in ICU 1 almost five times higher (22.60:4.54). In ICU 1, from fifty hypoglycemia episodes, twenty records were lower than 50mg/dL; in ICU 2, from forty-two hypoglycemia episodes, three records were lower than 50mg/dL. Severe hypoglycaemia in ICU 1 was 1.5 times smaller than the hypoglycemia by protocol; in ICU 2, severe hypoglycaemia was thirteen times smaller than the hypoglycemia by protocol. In ICU 1, from two thousand, two hundred and thirteen measurements, three hundred and seventy-five glucose measurements were below the target range. Of these measures, fifty were characterized as hypoglycemia (375:50). From seven or eight measures below the target range, one was hypoglycemia. In the ICU 2, from nine hundred and twenty-three measurements, two hundred and twenty-three measurements were below the target. From them, forty-two measures were hypoglycaemia (223:42). Therefore, for every five measures below the range, one was hypoglycemia. Considering that ICI in septic patients may contribute to better results, the nursing staff must be capable of making an effective glycemic control with less risk of hypoglycemia. Subsidizing the team with knowledge about the factors predisposing to hypoglycemia, as well as increase the nursing care level, provides indeed to reduce incidence of serious adverse events.O objeto de estudo é o resultado do controle glicêmico proveniente da infusão contínua de insulina (ICI) em pacientes sépticos da terapia intensiva. Os objetivos foram determinar a incidência de hipoglicemia encontrada entre pacientes de duas Unidades de Terapia Intensiva (UTI), que receberam ICI e sua relação com os valores da faixa-alvo de cada protocolo e discutir as implicações para a prática de enfermagem relacionadas à incidência de hipoglicemia. Trata-se de estudo transversal, bicêntrico, retrospectivo, com técnica de coleta de dados por análise do prontuário e avaliação quantitativa dos mesmos. Desenvolvida em duas UTIs, uma de um hospital de oncologia da rede federal e outra de um hospital geral da rede estadual do estado do Rio de Janeiro. As medidas glicêmicas de pacientes sépticos que utilizaram ICI no ano de 2010 nas duas UTIs foram transcritas para o instrumento de coleta de dados, gerando 2213 medidas em 29 pacientes (11,88%) na UTI 1 e 923 medidas em 20 pacientes (9,85%) na UTI 2. Os registros de hipoglicemia foram divididos em duas categorias: as medidas com valores definidos pelo protocolo adotado e aquelas com valores inferiores a 50mg/dL, caracterizados como hipoglicemia grave pelo Institute for Healthcare Improvement; nas duas categorias houve a necessidade de intervenção com a administração de glicose hipertônica a 50%. Dezesseis pacientes da UTI 1 apresentaram hipoglicemia, sendo quatro (25,00%) com medidas entre 50 e 60mg/dL e doze (75,00%) com medidas inferiores a 50mg/dL; treze pacientes da UTI 2 apresentaram hipoglicemia, sendo dez (76,92%) com medidas entre 50 e 80mg/dL e três (23,08%) com medidas inferiores a 50mg/dL. O cálculo da incidência considerou o total dos episódios de hipoglicemia independente da categoria. Comparando as duas UTIs, foi encontrada na UTI 1 uma incidência global de hipoglicemia quase cinco vezes maior (22,60:4,54). Na UTI 1, dos 50 episódios de hipoglicemia, 20 registros foram menores que 50mg/dL; na UTI 2, dos 42 episódios de hipoglicemia, 03 registros foram menores que 50mg/dL. A hipoglicemia grave na UTI 1 é 1,5 vezes menor que a hipoglicemia pelo protocolo; na UTI 2, a hipoglicemia grave é treze vezes menor que a hipoglicemia pelo protocolo. Na UTI 1, das 2213 medidas realizadas, 375 medidas glicêmicas ficaram abaixo da faixa alvo. Destas medidas, 50 se caracterizaram como hipoglicemia (375:50) A cada sete ou oito medidas abaixo da faixa-alvo, uma era de hipoglicemia. Na UTI 2, das 923 mensurações, 223 medidas ficaram abaixo do alvo. Destas, 42 medidas foram de hipoglicemia (223:42). Portanto, para cada cinco medidas abaixo da faixa, uma era de hipoglicemia. Considerando-se que a ICI em pacientes sépticos pode contribuir para melhores resultados, a equipe de enfermagem deve estar apta a realizar um controle glicêmico eficaz e com menor risco de hipoglicemia. Subsidiar a equipe com conhecimentos acerca dos fatores predisponentes à hipoglicemia, além de incrementar o nível da assistência de enfermagem prestada, possibilita que haja redução real na incidência deste evento adverso grave.Submitted by Boris Flegr (boris@uerj.br) on 2021-01-06T14:34:51Z No. of bitstreams: 1 DISSERTACAO_FINAL_MANASSES MOURA DOS SANTOS.pdf: 1821743 bytes, checksum: eff1dd8c0172e1f8c9b5b81602b083bf (MD5)Made available in DSpace on 2021-01-06T14:34:51Z (GMT). No. of bitstreams: 1 DISSERTACAO_FINAL_MANASSES MOURA DOS SANTOS.pdf: 1821743 bytes, checksum: eff1dd8c0172e1f8c9b5b81602b083bf (MD5) Previous issue date: 2012-02-16application/pdfporUniversidade do Estado do Rio de JaneiroPrograma de Pós-Graduação em EnfermagemUERJBRCentro Biomédico::Faculdade de EnfermagemIntensive careInsulinNursingCuidados intensivosInsulinaEnfermagemCNPQ::CIENCIAS DA SAUDE::ENFERMAGEMInfusão contínua de insulina e controle glicêmico em pacientes sépticos: implicações para a enfermagem em terapia intensivaContinuous infusion of insulin and glycemic control in septic patients: implications for nursing in intensive careinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UERJinstname:Universidade do Estado do Rio de Janeiro (UERJ)instacron:UERJORIGINALDISSERTACAO_FINAL_MANASSES MOURA DOS SANTOS.pdfapplication/pdf1821743http://www.bdtd.uerj.br/bitstream/1/11382/1/DISSERTACAO_FINAL_MANASSES+MOURA+DOS+SANTOS.pdfeff1dd8c0172e1f8c9b5b81602b083bfMD511/113822024-02-26 16:23:16.611oai:www.bdtd.uerj.br:1/11382Biblioteca Digital de Teses e Dissertaçõeshttp://www.bdtd.uerj.br/PUBhttps://www.bdtd.uerj.br:8443/oai/requestbdtd.suporte@uerj.bropendoar:29032024-02-26T19:23:16Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ)false |
dc.title.por.fl_str_mv |
Infusão contínua de insulina e controle glicêmico em pacientes sépticos: implicações para a enfermagem em terapia intensiva |
dc.title.alternative.eng.fl_str_mv |
Continuous infusion of insulin and glycemic control in septic patients: implications for nursing in intensive care |
title |
Infusão contínua de insulina e controle glicêmico em pacientes sépticos: implicações para a enfermagem em terapia intensiva |
spellingShingle |
Infusão contínua de insulina e controle glicêmico em pacientes sépticos: implicações para a enfermagem em terapia intensiva Santos, Manassés Moura dos Intensive care Insulin Nursing Cuidados intensivos Insulina Enfermagem CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM |
title_short |
Infusão contínua de insulina e controle glicêmico em pacientes sépticos: implicações para a enfermagem em terapia intensiva |
title_full |
Infusão contínua de insulina e controle glicêmico em pacientes sépticos: implicações para a enfermagem em terapia intensiva |
title_fullStr |
Infusão contínua de insulina e controle glicêmico em pacientes sépticos: implicações para a enfermagem em terapia intensiva |
title_full_unstemmed |
Infusão contínua de insulina e controle glicêmico em pacientes sépticos: implicações para a enfermagem em terapia intensiva |
title_sort |
Infusão contínua de insulina e controle glicêmico em pacientes sépticos: implicações para a enfermagem em terapia intensiva |
author |
Santos, Manassés Moura dos |
author_facet |
Santos, Manassés Moura dos |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Silva, Lolita Dopico da |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/5489255293217583 |
dc.contributor.referee1.fl_str_mv |
Silva, Roberto Carlos Lyra da |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/3110045515852703 |
dc.contributor.referee2.fl_str_mv |
Menezes, Maria de Fátima Batalha de |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/7149800876837659 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/6243108485236992 |
dc.contributor.author.fl_str_mv |
Santos, Manassés Moura dos |
contributor_str_mv |
Silva, Lolita Dopico da Silva, Roberto Carlos Lyra da Menezes, Maria de Fátima Batalha de |
dc.subject.eng.fl_str_mv |
Intensive care Insulin Nursing |
topic |
Intensive care Insulin Nursing Cuidados intensivos Insulina Enfermagem CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM |
dc.subject.por.fl_str_mv |
Cuidados intensivos Insulina Enfermagem |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM |
description |
This study aims to get the glycemic control result from the insulin continuous infusion (ICI) in septic patients in intensive care. The objectives were to determine the hypoglycemia incidence in patients from two Intensive Care Units (ICU) who received ICI and its relation to the target range values for each protocol, and discuss the implications for nursing practice related to hypoglycemia incidence. It is a bi-centric and retrospective cross-sectional study with data collection technique, by analyzing the records and their quantitative assessment. It was developed in two ICUs, one oncology hospital belonging to Union and another to state of Rio de Janeiro. Glycemic measures from septic patients who used ICI in 2010 in both ICUs were collected to data, yielding two thousand, two hundred and thirteen measured in twenty-nine patients (11.88%) from ICU 1, and nine hundred and twenty-three measures in twenty (9.85%) patients from ICU 2. Hypoglycemia records were divided into two categories, measures with values defined by the adopted protocol and measures with values less than 50mg/dL, characterized as severe hypoglycemia by the Institute for Healthcare Improvement. In both categories, it was necessary to intervene, administering hypertonic glucose of 50%. Sixteen patients from ICU 1 had hypoglycemia, four (25%) measuring between 50 and 60mg/dL and twelve (75%) with measures less than 50mg/dL. Thirteen patients from ICU 2 had hypoglycemia, ten (76.92%) measuring between 50 and 80mg/dL and three (23.08%) with measures less than 50mg/dL. For the incidence calculation, the total hypoglycemia episodes were considered independently of category. Comparing the two ICUs, global incidence of hypoglycemia was found in ICU 1 almost five times higher (22.60:4.54). In ICU 1, from fifty hypoglycemia episodes, twenty records were lower than 50mg/dL; in ICU 2, from forty-two hypoglycemia episodes, three records were lower than 50mg/dL. Severe hypoglycaemia in ICU 1 was 1.5 times smaller than the hypoglycemia by protocol; in ICU 2, severe hypoglycaemia was thirteen times smaller than the hypoglycemia by protocol. In ICU 1, from two thousand, two hundred and thirteen measurements, three hundred and seventy-five glucose measurements were below the target range. Of these measures, fifty were characterized as hypoglycemia (375:50). From seven or eight measures below the target range, one was hypoglycemia. In the ICU 2, from nine hundred and twenty-three measurements, two hundred and twenty-three measurements were below the target. From them, forty-two measures were hypoglycaemia (223:42). Therefore, for every five measures below the range, one was hypoglycemia. Considering that ICI in septic patients may contribute to better results, the nursing staff must be capable of making an effective glycemic control with less risk of hypoglycemia. Subsidizing the team with knowledge about the factors predisposing to hypoglycemia, as well as increase the nursing care level, provides indeed to reduce incidence of serious adverse events. |
publishDate |
2012 |
dc.date.issued.fl_str_mv |
2012-02-16 |
dc.date.available.fl_str_mv |
2015-07-14 |
dc.date.accessioned.fl_str_mv |
2021-01-06T14:34:51Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/masterThesis |
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masterThesis |
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publishedVersion |
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SANTOS, Manassés Moura dos. Infusão contínua de insulina e controle glicêmico em pacientes sépticos: implicações para a enfermagem em terapia intensiva. 2012. 121 f. Dissertação (Mestrado em Enfermagem) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2012. |
dc.identifier.uri.fl_str_mv |
http://www.bdtd.uerj.br/handle/1/11382 |
identifier_str_mv |
SANTOS, Manassés Moura dos. Infusão contínua de insulina e controle glicêmico em pacientes sépticos: implicações para a enfermagem em terapia intensiva. 2012. 121 f. Dissertação (Mestrado em Enfermagem) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2012. |
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http://www.bdtd.uerj.br/handle/1/11382 |
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BR |
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Centro Biomédico::Faculdade de Enfermagem |
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Universidade do Estado do Rio de Janeiro |
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