{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T18:15:06Z","timestamp":1774635306772,"version":"3.50.1"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2005,12,1]],"date-time":"2005-12-01T00:00:00Z","timestamp":1133395200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Inform Decis Mak"],"published-print":{"date-parts":[[2005,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Tight glucose control by intensive insulin therapy has become a key part of critical care and is an important field of study in acute coronary care. A balance has to be found between frequency of measurements and the risk of hypoglycemia. Current nurse-driven protocols are paper-based and, therefore, rely on simple rules. For safety and efficiency a computer decision support system that employs complex logic may be superior to paper protocols.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We designed and implemented GRIP, a stand-alone Java computer program. Our implementation of GRIP will be released as free software. Blood glucose values measured by a point-of-care analyzer were automatically retrieved from the central laboratory database. Additional clinical information was asked from the nurse and the program subsequently advised a new insulin pump rate and glucose sampling interval.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Implementation of the computer program was uneventful and successful. GRIP treated 179 patients for a total of 957 patient-days. Severe hypoglycemia (&lt; 2.2 mmol\/L) only occurred once due to human error. With a median (IQR) of 4.9 (4.2 \u2013 6.2) glucose measurements per day the median percentage of time in which glucose fell in the target range was 78%. Nurses rated the program as easy to work with and as an improvement over the preceding paper protocol. They reported no increase in time spent on glucose control.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>A computer driven protocol is a safe and effective means of glucose control at a surgical ICU. Future improvements in the recommendation algorithm may further improve safety and efficiency.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1472-6947-5-38","type":"journal-article","created":{"date-parts":[[2005,12,20]],"date-time":"2005-12-20T07:13:47Z","timestamp":1135062827000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":99,"title":["Design and implementation of GRIP: a computerized glucose control system at a surgical intensive care unit"],"prefix":"10.1186","volume":"5","author":[{"given":"Mathijs","family":"Vogelzang","sequence":"first","affiliation":[]},{"given":"Felix","family":"Zijlstra","sequence":"additional","affiliation":[]},{"given":"Maarten WN","family":"Nijsten","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2005,12,19]]},"reference":[{"issue":"4","key":"89_CR1","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1053\/beem.2001.0168","volume":"15","author":"BA Mizock","year":"2001","unstructured":"Mizock BA: Alterations in fuel metabolism in critical illness: hyperglycaemia. Best Pract Res Clin Endocrinol Metab. 2001, 15 (4): 533-551. 10.1053\/beem.2001.0168.","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"issue":"3","key":"89_CR2","doi-asserted-by":"publisher","first-page":"978","DOI":"10.1210\/jcem.87.3.8341","volume":"87","author":"GE Umpierrez","year":"2002","unstructured":"Umpierrez GE, Isaacs SD, Bazargan N, You X, Thaler LM, Kitabchi AE: Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes. J Clin Endocrinol Metab. 2002, 87 (3): 978-982. 10.1210\/jc.87.3.978.","journal-title":"J Clin Endocrinol Metab"},{"issue":"9206","key":"89_CR3","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1016\/S0140-6736(99)08415-9","volume":"355","author":"SE Capes","year":"2000","unstructured":"Capes SE, Hunt D, Malmberg K, Gerstein HC: Stress hyperglycaemia and increased risk of death after myocardial infarction in patients with and without diabetes: a systematic overview. Lancet. 2000, 355 (9206): 773-778. 10.1016\/S0140-6736(99)08415-9.","journal-title":"Lancet"},{"issue":"10","key":"89_CR4","doi-asserted-by":"publisher","first-page":"2426","DOI":"10.1161\/hs1001.096194","volume":"32","author":"SE Capes","year":"2001","unstructured":"Capes SE, Hunt D, Malmberg K, Pathak P, Gerstein HC: Stress hyperglycemia and prognosis of stroke in nondiabetic and diabetic patients: a systematic overview. Stroke. 2001, 32 (10): 2426-2432.","journal-title":"Stroke"},{"issue":"19","key":"89_CR5","doi-asserted-by":"publisher","first-page":"1359","DOI":"10.1056\/NEJMoa011300","volume":"345","author":"G van den Berghe","year":"2001","unstructured":"van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P, Bouillon R: Intensive insulin therapy in critically ill patients. N Engl J Med. 2001, 345 (19): 1359-1367. 10.1056\/NEJMoa011300.","journal-title":"N Engl J Med"},{"issue":"8","key":"89_CR6","doi-asserted-by":"publisher","first-page":"992","DOI":"10.4065\/79.8.992","volume":"79","author":"JS Krinsley","year":"2004","unstructured":"Krinsley JS: Effect of an intensive glucose management protocol on the mortality of critically ill adult patients. Mayo Clin Proc. 2004, 79 (8): 992-1000.","journal-title":"Mayo Clin Proc"},{"issue":"3","key":"89_CR7","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1097\/01.CCM.0000117317.18092.E4","volume":"32","author":"RP Dellinger","year":"2004","unstructured":"Dellinger RP, Carlet JM, Masur H, Gerlach H, Calandra T, Cohen J, Gea-Banacloche J, Keh D, Marshall JC, Parker MM, Ramsay G, Zimmerman JL, Vincent JL, Levy MM, Surviving Sepsis Campaign Management Guidelines Committee: Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock. Crit Care Med. 2004, 32 (3): 858-873. 10.1097\/01.CCM.0000117317.18092.E4.","journal-title":"Crit Care Med"},{"issue":"9","key":"89_CR8","doi-asserted-by":"publisher","first-page":"1714","DOI":"10.1097\/00003246-200109000-00010","volume":"29","author":"G Brown","year":"2001","unstructured":"Brown G, Dodek P: Intravenous insulin nomogram improves blood glucose control in the critically ill. Crit Care Med. 2001, 29 (9): 1714-1719. 10.1097\/00003246-200109000-00010.","journal-title":"Crit Care Med"},{"issue":"2","key":"89_CR9","doi-asserted-by":"publisher","first-page":"461","DOI":"10.2337\/diacare.27.2.461","volume":"27","author":"PA Goldberg","year":"2004","unstructured":"Goldberg PA, Siegel MD, Sherwin RS, Halickman JI, Lee M, Bailey VA, Lee SL, Dziura JD, Inzucchi SE: Implementation of a safe and effective insulin infusion protocol in a medical intensive care unit. Diabetes Care. 2004, 27 (2): 461-467.","journal-title":"Diabetes Care"},{"issue":"3","key":"89_CR10","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1592\/phco.25.3.352.61594","volume":"25","author":"C Chant","year":"2005","unstructured":"Chant C, Wilson G, Friedrich JO: Validation of an insulin infusion nomogram for intensive glucose control in critically ill patients. Pharmacotherapy. 2005, 25 (3): 352-359. 10.1592\/phco.25.3.352.61594.","journal-title":"Pharmacotherapy"},{"issue":"5","key":"89_CR11","doi-asserted-by":"publisher","first-page":"784","DOI":"10.1016\/S0735-1097(03)00830-1","volume":"42","author":"IC van der Horst","year":"2003","unstructured":"van der Horst IC, Zijlstra F, van't Hof AW, Doggen CJ, de Boer MJ, Suryapranata H, Hoorntje JC, Dambrink JH, Gans RO, Bilo HJ, Zwolle Infarct Study Group: Glucose-insulin-potassium infusion in patients treated with primary angioplasty for acute myocardial infarction: the glucose-insulin-potassium study: a randomized trial. J Am Coll Cardiol. 2003, 42 (5): 784-791. 10.1016\/S0735-1097(03)00830-1.","journal-title":"J Am Coll Cardiol"},{"issue":"4","key":"89_CR12","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1001\/jama.293.4.437","volume":"293","author":"SR Mehta","year":"2005","unstructured":"Mehta SR, Yusuf S, D\u00edaz R, Zhu J, Pais P, Xavier D, Paolasso E, Ahmed R, Xie C, Kazmi K, Tai J, Orlandini A, Pogue J, Liu L, CREATE-ECLA Trial Group Investigators: Effect of glucose-insulin-potassium infusion on mortality in patients with acute ST-segment elevation myocardial infarction: the CREATE-ECLA randomized controlled trial. JAMA. 2005, 293 (4): 437-446. 10.1001\/jama.293.14.1746.","journal-title":"JAMA"},{"key":"89_CR13","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/0735-1097(95)00126-K","volume":"26","author":"K Malmberg","year":"1995","unstructured":"Malmberg K, Ryd\u00e9n L, Efendic S, Herlitz J, Nicol P, Waldenstr\u00f6m A, Wedel H, Welin L: Randomized trial of insulin-glucose infusion followed by subcutaneous insulin treatment in diabetic patients with acute myocardial infarction (DIGAMI study): effects on mortality at 1 year. J Am Coll Cardiol. 1995, 26: 57-65. 10.1016\/0735-1097(95)00126-K.","journal-title":"J Am Coll Cardiol"},{"issue":"7","key":"89_CR14","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1093\/eurheartj\/ehi199","volume":"26","author":"K Malmberg","year":"2005","unstructured":"Malmberg K, Ryd\u00e9n L, Wedel H, Birkeland K, Bootsma A, Dickstein K, Efendic S, Fisher M, Hamsten A, Herlitz J, Hildebrandt P, MacLeod K, Laakso M, Torp-Pedersen C, Waldenstr\u00f6m A, DIGAMI 2 Investigators : Intense metabolic control by means of insulin in patients with diabetes mellitus and acute myocardial infarction (DIGAMI 2): effects on mortality and morbidity. Eur Heart J. 2005, 26 (7): 650-661. 10.1093\/eurheartj\/ehi199.","journal-title":"Eur Heart J"},{"issue":"7494","key":"89_CR15","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1136\/bmj.38398.500764.8F","volume":"330","author":"K Kawamoto","year":"2005","unstructured":"Kawamoto K, Houlihan CA, Balas EA, Lobach DF: Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success. BMJ. 2005, 330 (7494): 765-10.1136\/bmj.38398.500764.8F.","journal-title":"BMJ"},{"issue":"2","key":"89_CR16","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1172\/JCI118441","volume":"97","author":"RL Prigeon","year":"1996","unstructured":"Prigeon RL, R\u00f8der ME, Porte D, Kahn SE: The effect of insulin dose on the measurement of insulin sensitivity by the minimal model technique. Evidence for saturable insulin transport in humans. J Clin Invest. 1996, 97 (2): 501-507.","journal-title":"J Clin Invest"},{"issue":"15","key":"89_CR17","doi-asserted-by":"publisher","first-page":"2041","DOI":"10.1001\/jama.290.15.2041","volume":"290","author":"SJ Finney","year":"2003","unstructured":"Finney SJ, Zekveld C, Elia A, Evans TW: Glucose control and mortality in critically ill patients. JAMA. 2003, 290 (15): 2041-2047. 10.1001\/jama.290.15.2041.","journal-title":"JAMA"},{"issue":"10","key":"89_CR18","doi-asserted-by":"publisher","first-page":"1198","DOI":"10.1001\/jama.291.10.1198-b","volume":"291","author":"G van den Berghe","year":"2004","unstructured":"van den Berghe G, Bouillon R: Optimal control of glycemia among critically ill patients. JAMA. 2004, 291 (10): 1198-1199. 10.1001\/jama.291.10.1198-b.","journal-title":"JAMA"},{"issue":"2","key":"89_CR19","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1089\/dia.2005.7.274","volume":"7","author":"JG Chase","year":"2005","unstructured":"Chase JG, Shaw GM, Lin J, Doran CV, Hann C, Lotz T, Wake GC, Broughton B: Targeted glycemic reduction in critical care using closed-loop control. Diabetes Technol Ther. 2005, 7 (2): 274-282. 10.1089\/dia.2005.7.274.","journal-title":"Diabetes Technol Ther"},{"key":"89_CR20","unstructured":"Free Software Foundation: GNU General Public License. [http:\/\/www.gnu.org\/licenses\/gpl.html]"},{"issue":"3","key":"89_CR21","doi-asserted-by":"publisher","first-page":"R122","DOI":"10.1186\/cc2840","volume":"8","author":"M Vogelzang","year":"2004","unstructured":"Vogelzang M, van der Horst IC, Nijsten MW: Hyperglycaemic index as a tool to assess glucose control: a retrospective study. Crit Care. 2004, 8 (3): R122-R127. 10.1186\/cc2840.","journal-title":"Crit Care"},{"issue":"4","key":"89_CR22","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1109\/TITB.2003.821326","volume":"7","author":"F Chee","year":"2003","unstructured":"Chee F, Fernando TL, Savkin AV, van Heeden V: Expert PID control system for blood glucose control in critically ill patients. IEEE Trans Inf Technol Biomed. 2003, 7 (4): 419-425. 10.1109\/TITB.2003.821326.","journal-title":"IEEE Trans Inf Technol Biomed"},{"issue":"3","key":"89_CR23","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1089\/152091504774198034","volume":"6","author":"PA Goldberg","year":"2004","unstructured":"Goldberg PA, Siegel MD, Russell RR, Sherwin RS, Halickman JI, Cooper DA, Dziura JD, Inzucchi SE: Experience with the continuous glucose monitoring system in a medical intensive care unit. Diabetes Technol Ther. 2004, 6 (3): 339-347. 10.1089\/152091504774198034.","journal-title":"Diabetes Technol Ther"},{"issue":"3","key":"89_CR24","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1016\/j.cmpb.2004.10.006","volume":"77","author":"CE Hann","year":"2005","unstructured":"Hann CE, Chase JG, Lin J, Lotz T, Doran CV, Shaw GM: Integral-based parameter identification for long-term dynamic verification of a glucose-insulin system model. Comput Methods Programs Biomed. 2005, 77 (3): 259-270. 10.1016\/j.cmpb.2004.10.006.","journal-title":"Comput Methods Programs Biomed"},{"issue":"2","key":"89_CR25","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1197\/jamia.M1598","volume":"12","author":"E Rood","year":"2005","unstructured":"Rood E, Bosman RJ, van der Spoel JI, Taylor P, Zandstra DF: Use of a computerized guideline for glucose regulation in the intensive care unit improved both guideline adherence and glucose regulation. J Am Med Inform Assoc. 2005, 12 (2): 172-180. 10.1197\/jamia.M1598.","journal-title":"J Am Med Inform Assoc"}],"container-title":["BMC Medical Informatics and Decision Making"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1472-6947-5-38.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/1472-6947-5-38\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1472-6947-5-38","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1472-6947-5-38.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T01:45:17Z","timestamp":1630460717000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmedinformdecismak.biomedcentral.com\/articles\/10.1186\/1472-6947-5-38"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,12]]},"references-count":25,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2005,12]]}},"alternative-id":["89"],"URL":"https:\/\/doi.org\/10.1186\/1472-6947-5-38","relation":{},"ISSN":["1472-6947"],"issn-type":[{"value":"1472-6947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,12]]},"assertion":[{"value":"5 September 2005","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 December 2005","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 December 2005","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"38"}}