Objective

This prospective study compares post-operative glycemic control for cardiac surgery patients before and after implementation of a software-based tool for insulin dosing (EndoTool).

Setting

800-bed hospital, Level II trauma center and regional referral center for tertiary and quaternary care.

Results

• Time to control in the cardiovascular recovery unit decreased 78% with EndoTool, from 9 hours to just over 2 hours.
• Percentage of CABG patients who achieved the optimal blood glucose range of 71-150 mg/dL in the cardiovascular intensive care unit more than quadrupled with EndoTool, from 17% to 91.5%.
• Mean average incidence of hypoglycemia <70 mg/dL decreased 84% with EndoTool, from 3% to 0.48% of blood glucose measurements.

Conclusions

There is overwhelming evidence that a software-based tool for insulin dosing (EndoTool) improves glycemic control for cardiac surgery patients; additional benefits include projected cost savings from decreased length of stay and mortality as well as overall simplicity of use, ability to customize based on service line/patient population, and user support.