关键词: 胰岛素输注, 危重症, 重症监护病房, 血糖管理, 高血糖, 低血糖, 证据总结, 循证护理学

Abstract:

Objective To search，evaluate，and synthesize the relevant evidence for the management of insulin intravenous infusion in ICU patients and summarize the best evidence. Methods We searched Guidelines International Network（GIN），National Institute for Health and Care Excellence（NICE），National Guideline Clearinghouse（NGC），Registered Nurse Association of Ontario（RNAO），Scottish Intercollegiate Guidelines Network（SIGN），BMJ Best Practice，JBI，Cochrane Library，PubMed，Embase，CINAHL，UpToDate，SinoMed，CNKI，Wangfang Database and clinical guidelines APP to collect clinical decisions，guidelines，evidence summaries，expert consensuses related to insulin intravenous infusion management of adult patients in ICU. Through literature quality evaluation，the evidence was extracted from the literature that met the quality standards. The search period is from the inception to August 31，2022. Literature screening and quality evaluation were conducted independently by 2 researchers，and the evidence was extracted and summarized according to the subject. Results A total of 8 articles were selected，including 2 guidelines，1 systematic review，4 evidence summaries and 1 expert consensus. Finally，19 pieces of best evidence were formed in 4 aspects，including blood glucose control target，blood glucose monitoring，insulin infusion and hypoglycemia disposal. Conclusion The study summarizes the best evidence for blood glucose monitoring，insulin infusion，and hypoglycemia management during intravenous insulin infusion in critically ill patients，which provides a basis for clinical nursing practice. Nursing staff can reasonably select the best evidence for localization application according to clinical situation to promote the management of ICU patients with intravenous insulin infusion.

Key words: Insulin Intravenous Infusion, Critical Illness, Intensive Care Unit, Blood Glucose Management, Hyperglycemia, Hypoglycemia, Evidence Summary, Evidence-Based Nursing