CHSU Discovery

Abstract:

Introduction: Hypertriglyceridemia associated acute pancreatitis is a disease lacking a standardized management approach. The objective of this study was to evaluate the safety and efficacy of a continuous intravenous insulin infusion order set specifically designed for managing hypertriglyceridemia.

Methods: This study compared the safety and efficacy of a standardized (post-intervention) approach to managing hypertriglyceridemia to a non-standardized (pre-intervention) approach. The primary efficacy outcome was the percentage of patients who achieved a triglyceride level less than 500 mg/dL. Additional outcomes included the time to achieving a triglyceride level less than 500 mg/dL and the percent reduction in triglyceride levels. The primary safety outcome was the number of patients who experienced hypoglycemia (glucose less than 70 mg/dL).

Results: Twenty patients were included in both the pre- and post-intervention groups. There was a significantly greater reduction in triglyceride levels observed in the post-intervention group. The number of patients who achieved a triglyceride level less than 500 mg/dL in the pre- and post-intervention groups were 10 (50%) and 17 (85%), respectively, p = 0.018. Within the post-intervention group, the time to achieving a triglyceride level less than 500 mg/dL in those with and without diabetes was 56.8 hours (38.2-64.0) vs 27.6 hours (19.7-45.0), respectively, p = 0.028.

Conclusion: Our findings demonstrate that insulin infusions are safe and effective when therapy is standardized and accounts for nursing to patient ratios. Our results provide the medical community with a standardized approach to acutely managing hypertriglyceridemia.