Introduction: There is minimal literature to support the appropriate dosing for the initiation of IV regular insulin therapy in DKA patients. A 0.1 unit/kg bolus followed by 0.1 units/kg/hour or 0.14 units/kg/hour is ...Introduction: There is minimal literature to support the appropriate dosing for the initiation of IV regular insulin therapy in DKA patients. A 0.1 unit/kg bolus followed by 0.1 units/kg/hour or 0.14 units/kg/hour is commonly utilized and recommended in guidelines. Objective: We sought to assess clinical and safety outcomes associated with various insulin infusion starting doses in patients diagnosed with DKA in the emergency department in an effort to help guide prescribing. Methods: A retrospective cohort study was conducted within an academic emergency department and included patients who received continuous infusion regular insulin with an ICD-10 code for DKA between January 2016 and January 2019. A predictive regression model was applied to test if predefined lab values influenced the starting insulin infusion rates. Clinical and safety outcomes were evaluated by starting insulin infusion rate. Data was analyzed based on starting insulin infusion rates. Results: 347 patients met inclusion criteria with 92 (26.5%) patients receiving Conclusion: Glucose levels significantly influenced the insulin starting infusion rate, with no identified differences in adverse effects or clinical outcomes.展开更多
The safe and efficacy of diltiazem in ventricular rate control of atrialfibrillation are the major concern to most clinicians in patients with heartfailure.We tested the performance of acute application of diltiazem i...The safe and efficacy of diltiazem in ventricular rate control of atrialfibrillation are the major concern to most clinicians in patients with heartfailure.We tested the performance of acute application of diltiazem inpatients with heart failure and atrial fibrillation or flutter.A total of 280patients were grouped according to the New York heart failureclassification,with class IV in 48 patients.All the patients receiveddiltiazem 10-20mg intravenous injection and/or 10mg/h intravenousinfusion during arrhythmia.After the drag injection or infusion,theventricular rate decreased from 142.09±17.61 to 100.24±17.74 beatper minute(P【0.0001),the systolic blood pressure dropped from135.44+28.14 to 123.52±19.18 mmHg(P【0.001),the diastolic bloodpressure dropped from 84.52±16.04 to 77.26±12.02mmHg(P【0.01).Despite the decrease in blood pressure,no deteriorate symptom wasnoted in all the groups of patients.Our results suggest that the diltiazemis a safe and effective drug to control the ventricular rate during atrialfibrillation or flutter associated with heart failure.展开更多
文摘Introduction: There is minimal literature to support the appropriate dosing for the initiation of IV regular insulin therapy in DKA patients. A 0.1 unit/kg bolus followed by 0.1 units/kg/hour or 0.14 units/kg/hour is commonly utilized and recommended in guidelines. Objective: We sought to assess clinical and safety outcomes associated with various insulin infusion starting doses in patients diagnosed with DKA in the emergency department in an effort to help guide prescribing. Methods: A retrospective cohort study was conducted within an academic emergency department and included patients who received continuous infusion regular insulin with an ICD-10 code for DKA between January 2016 and January 2019. A predictive regression model was applied to test if predefined lab values influenced the starting insulin infusion rates. Clinical and safety outcomes were evaluated by starting insulin infusion rate. Data was analyzed based on starting insulin infusion rates. Results: 347 patients met inclusion criteria with 92 (26.5%) patients receiving Conclusion: Glucose levels significantly influenced the insulin starting infusion rate, with no identified differences in adverse effects or clinical outcomes.
文摘The safe and efficacy of diltiazem in ventricular rate control of atrialfibrillation are the major concern to most clinicians in patients with heartfailure.We tested the performance of acute application of diltiazem inpatients with heart failure and atrial fibrillation or flutter.A total of 280patients were grouped according to the New York heart failureclassification,with class IV in 48 patients.All the patients receiveddiltiazem 10-20mg intravenous injection and/or 10mg/h intravenousinfusion during arrhythmia.After the drag injection or infusion,theventricular rate decreased from 142.09±17.61 to 100.24±17.74 beatper minute(P【0.0001),the systolic blood pressure dropped from135.44+28.14 to 123.52±19.18 mmHg(P【0.001),the diastolic bloodpressure dropped from 84.52±16.04 to 77.26±12.02mmHg(P【0.01).Despite the decrease in blood pressure,no deteriorate symptom wasnoted in all the groups of patients.Our results suggest that the diltiazemis a safe and effective drug to control the ventricular rate during atrialfibrillation or flutter associated with heart failure.
