Objective

This retrospective study evaluates the safety and efficacy of EndoTool software for tight glucose control in the ICU.

Setting

874-bed regional academic medical center.

Results

• Incidence of hypoglycemia <=40 mg/dL was 0.13% of blood glucose readings, and incidence of hypoglycemia <=60 mg/dL was 0.97% of blood glucose readings.
• Some blood glucose readings <=40 mg/dL and <=60 mg/dL were associated with late blood glucose determinations.
• Mean blood glucose was 121 mg/dL (± 38).
• Mean blood glucose after 4 hours of control was 118 mg/dL (± 38).
• Time to control <150 mg/dL was 2.7, 3.4, 4.5 and 5.0 hours for starting ranges of 151-200, 201-250, 251-300 and >300 mg/dL, respectively.
• Critical care staff were supportive of EndoTool software for patient care and recommended it over previous paper protocols; they were instrumental in promoting it throughout the hospital.
• Physician calls were basically eliminated.
• Work and stress associated with tight glucose control was subjectively reduced.
• Medical record documentation of care was simplified and improved. Quality assurance was convenient and easy.

Conclusions

Use of EndoTool software is shown to be both safe and effective, with very low incidence of hypoglycemia, and is recommended by critical care staff over paper protocols for tight glycemic control in the ICU.