What are the origins of tight glycemic control protocols?
A. Tight glycemic control protocols started because of the direct relationships that have been discovered between hyperglycemia and adverse in-hospital outcomes. Increasing hyperglycemia has been independently shown to cause increased infection rates, increased mortality in CABG patients, and increased length of stay. Conversely, tight glycemic control protocols have been shown to independently reduce in-hospital mortality, LOS, and infection rates. The Portland Diabetic Project was the first to elucidate these findings with publications starting in 1995. Other publications from our center followed in 1997, 1999, 2000 and 2003. Corroborating data from other centers began to appear in 2000. Since then there has been an explosion of interest in tight glycemic control. There are currently several glycemic control protocols available. Ours, known as “The Portland Protocol,” has been in use since 1992. Over the past 14 years, it has been repeatedly modified and honed to provide what we beli
- Is there any reason a patient wouldn be eligible for the tight glycemic control protocol? Is there a checklist that you use for determining eligibility?
- Has tight glycemic control been examined in pediatric populations, particularly after neonatal and infant congenital heart surgery?
- Could you point to any peer-reviewed clinical guidelines that incorporate tight glycemic control in the ICU?