TPN 투여 환자에서 고혈당증 조절을 위한 Insulin 투여량

Abstract

Hyperglycemia is a common complication related to TPN administration. Because uncontrolled hyperglycemia results in electrolyte imbalance, decrease of immune function, increase of muscle protein catabolism, nonketogenic coma and increase of mortality, it is an obstacle of effective nutritional support. If stable blood sugar level maintain through appropriate administration of insulin, we can plan safe nutritional support for the critically ill patient needed to TPN administration. Objectives of this study were to yield appropriate insulin dose needed to control TPN-induced hyperglycemia and analysis the risk factor affected to hyperglycemia. EMR of 40 patients using insulin due to TPN induced hyperglycemia was reviewed from May of 2003 to Sep. of 2004. Exclusion criteria is not NPO state, concurrent oral intake, using NPH, unstable blood sugar level. In stable blood sugar level after administration insulin, yield insulin requirement per glucose, analysis the effect of risk factor on hyperglycemia. Insulin requirement per glucose is in total patient group, in DM patient, in non-DM patient 0.141 IU/g, 0.162 IU/g, 0.118 IU/g. In all patient group ICU patient, GIR, sepsis increase the insulin requirement. (α=0.05)