Named one of the 100 Top Cardiovascular Hospitals in the nation, Holy Cross Hospital is a 571-bed hospital in seaside Broward County, Florida. Embracing a strategic intervention for unconscious cardiac arrest, brain injury and stroke patients, Holy Cross successfully introduced a hypothermia program. This program reduces core body temperature below 94° F [35° C] to improve neurologic recovery.

However, such a dramatic change launches a host of related physiologic consequences, mostly undesirable. One is a decrease in insulin sensitivity and secretion, often resulting in hyperglycemia.  Patients already suffering multiple complications are often extremely vulnerable to the impact of these high blood sugar levels.

To address this problem initially, Holy Cross relied on its existing paper-based protocol for intravenous insulin dosing for these patients. Despite hourly insulin checks combined with hourly upward titration of the insulin protocol, patients remained hyperglycemic. When circulating blood glucose levels dropped, patients were then removed from insulin drips with little control, resulting in the familiar pattern of alternating hyperglycemia and hypoglycemia.

Two years into the program without satisfaction, Holy Cross implemented the EndoTool IV application to individualize insulin dosing. As a new patient is added, the software uses previous blood glucose readings and various clinical data points to customize their dosing curve. Following this, nurses input current glucose readings and dosing is automatically adjusted. The frequency of patient glucose checks rapidly diminished from every half hour to every two hours as glucose levels stabilized.

As a result of eliminating risk factors and time bottlenecks, patients completing hypothermia treatment at Holy Cross Hospital were safely removed from the insulin drip without experiencing hyperglycemia or negative side effects.