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Table 4 Special cases definitions and outcome impact on interventions and measurement interval

From: Pilot proof of concept clinical trials of Stochastic Targeted (STAR) glycemic control

Case Condition Outcome Maximum measurement interval (h)
Gradual reduction of hyperglycemia BGi > 7.5 mmol/L Percentile used for Targeting 50th 1
    Target Value 0.85 × BGi  
Rapid decrease in glucose levels BGi < BGi-1 (5th) - 1 BGi < 5.0 Background insulin infusions stopped 1
   BGi ≥ 5.0 Background insulin infusions stopped  
Nutrition suspension Feed turned off by clinician Use only insulin intervention
Stop all extra insulin infusions
2
Added insulin infusion of 1 U/h over 6 U/h maximum Must meet:
• Insulin at ≥5 U/h, for the past 3 hours
• At least 4 hours has elapsed since the last time the enteral feed was turned off
Add 1 U/h insulin infusion on top of 6 U/h maximum level
This infusion is maintained for 6 hours unless:
A) Nutrition is stopped for any reason
B) If "Rapid Decrease in Glucose Levels" is detected
C) BG predicted to be below lower cceptable limit with insulin infusion
1-3 hours as chosen by nurse