Objective

To assess the impact of EndoTool IV, insulin dosing software, on clinical outcomes in two critical care units.

Setting

Comparison of patient outcomes pre-and post EndoTool IV implementation in two critical care units at UPMC Central PA over three months.

Results

• Insulin Infusion Duration: After implementing ETIV, there was a substantial reduction in the average time patients spent on insulin infusion, decreasing from 58.16 hours to 41.4 hours.
• Blood Glucose Management: The average time to reach the target blood glucose level of 140 mg/dl was significantly reduced from 18 hours and 15 minutes to just 4.7 hours. Furthermore, the rate of hypoglycemic events (blood glucose < 70 mg/dl) decreased from 2.11% to 0.530%.
• Hospital Stay Metrics:
  • ICU Length of Stay (LOS): The average ICU LOS decreased from 5.3 days to 4.76 days.
  • Hospital LOS: There was a reduction in the average hospital stay from 11 days to 8.6 days.
• Cost Implications: The average ICU charges per patient saw a decrease, going from $42,032 to $32,162.
• Blood Glucose Monitoring Frequency: The average number of blood glucose checks while on an insulin drip reduced from 67 to 31.2 checks.
• Severe Hypoglycemia: Complete elimination of severe hypoglycemia (blood glucose < 40 mg/dl) post-ETIV implementation, compared to 0.14% pre-implementation.

Conclusions

These results demonstrate the effectiveness of EndoTool IV in improving glycemic control, reducing the duration of insulin infusion, and minimizing the incidence of hypoglycemic events in critically ill patients. Additionally, the reduction in ICU and overall hospital stay, along with a decrease in ICU charges, suggests potential cost-effectiveness of this intervention.