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Target ranges and the apparent compliance with tight glycaemic control
Author(s) -
Bone E. G.,
Young D.,
Chantler J.
Publication year - 2006
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2006.04817.x
Subject(s) - medicine , target range , audit , compliance (psychology) , retrospective cohort study , accounting , psychology , social psychology , business , economics , macroeconomics
Summary We performed a retrospective audit of blood glucose control after introducing a new protocol for insulin infusion. The audit showed a sustained reduction in the median blood glucose, which decreased from 7.0 to 6.8 mmol.l −1 , primarily because of a reduction in the proportion of values above 6 mmol.l −1 . When we examined the proportion of readings with previously published ‘acceptable’ ranges we found that small, probably clinically insignificant, changes in the accepted range have a major effect on apparent compliance with glycaemic control. This is because a large number of results fall within a narrow range of values. As a result there is a nearly 2.5‐fold difference in compliance for a change in the upper limit of the target range of just 2.2 mmol.l −1 . Different target ranges have been recommended for tight glycaemic control. When comparing compliance with tight glycaemic control between intensive care units, target ranges should be identical.