Info

Increase by 0.6 U/h

> 300 mg/dL

Increase by 1 U/h

Note: Typical initial infusion rate 0.02 U kg-1 h-1 (~ 1.0—1.5 U-1 h-1) may be adjusted higher for patients with insulin resistance, and lower for insulin-sensitive patients. Surgical patients generally require 0.3 to 0.4 U of insulin per gram of glucose infused per hour. Higher infusion rates are required in some patients with liver disease (0.5-0.6 U g-1 h-1), sepsis (0.6-0.8 U g-1 h-1), obesity (0.4-0.6 U gh-1), and those receiving catecholamine or glucocorticoid therapy (0.5-0.8 U g-1 h-1). Lower infusion rates may be required with hepatic, renal, or congestive heart failure. Large doses of insulin are often required during anesthesia and surgery (especially hypothermic cardiopulmonary bypass) to counter the effects of insulin resistance. Frequent BG monitoring is required in the immediate postoperative period to avoid hypoglycemia following the resolution of insulin resistance. Source: From Refs. 14, 15, 16, 17, 48, 54, 55, 56.

TABLE 4 Variable-Rate Insulin/Variable-Rate Glucose Infusion Regimen for Tight Blood Glucose Control

Blood glucose (mg/dL) Intravenous insulin dose (U/h) 10% Glucose infusion rate (ml/h)

TABLE 4 Variable-Rate Insulin/Variable-Rate Glucose Infusion Regimen for Tight Blood Glucose Control

Blood glucose (mg/dL) Intravenous insulin dose (U/h) 10% Glucose infusion rate (ml/h)

< 70

discontinue infusion3

75 ml/h

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