Errors in preparation of insulin infusions for critically ill patients

Excerpt

Dysglycaemia is associated with poorer outcomes in critically ill patients. Maintenance of normoglycaemia by the administration of intravenous insulin is an important therapy in the ICU, but many factors can affect plasma glucose levels in often unpredictable ways. Even if insulin could be delivered to patients at a guaranteed rate, the process of controlling glucose levels with exogenous insulin infusions is not straightforward. The preparation and administration of any drug for infusion is potentially subject to error. Insulin infusions are of particular concern, since they must be diluted from a concentrated stock solution. Random errors in the preparation of insulin infusions could result in significant differences between the concentration of insulin prescribed and that seen in the infusion. This would affect the rate of insulin delivery and could potentially result in unstable plasma glucose levels. …