Table 4.
Special cases definitions and outcome impact on interventions and measurement interval
| Case | Condition | Outcome | Maximum measurement interval (h) | ||
|---|---|---|---|---|---|
| Gradual reduction of hyperglycemia | BGi > 7.5 mmol/L | Percentile used for Targeting | 50th | 1 | |
| Target Value | 0.85 × BGi | ||||
| Rapid decrease in glucose levels | BGi < BGi-1 (5th) - 1 | BGi < 5.0 | Background insulin infusions stopped | 1 | |
| BGi ≥ 5.0 | Background insulin infusions stopped | ||||
| Nutrition suspension | Feed turned off by clinician | Use only insulin intervention Stop all extra insulin infusions |
2 | ||
| Added insulin infusion of 1 U/h over 6 U/h maximum | Must meet: • Insulin at ≥5 U/h, for the past 3 hours • At least 4 hours has elapsed since the last time the enteral feed was turned off |
Add 1 U/h insulin infusion on top of 6 U/h maximum level This infusion is maintained for 6 hours unless: A) Nutrition is stopped for any reason B) If "Rapid Decrease in Glucose Levels" is detected C) BG predicted to be below lower cceptable limit with insulin infusion |
1-3 hours as chosen by nurse | ||