Intravenous Insulin Protocol for Cardiac Surgery Glycemic Control

Consider intravenous regular insulin infusion if blood glucose is greater than 8.5 mmol/L.
Goal blood glucose is 6.5-8.5 mmol/L.
Discontinue all previous orders for insulin and oral hypoglycemic agents.
If nutrition is stopped, decrease insulin infusion by 50% and monitor blood glucose every hour.
Insulin solution is 1 unit of regular insulin per 1 ml of 0.9% NaCl.
Initial insulin bolus is 0.1 units/kg, to a maximum of 10 units.
Initial insulin dose is 0.1 units/kg per hour, to a maximum of 10 units/hr.
Monitor patient's finger stick blood blood glucose every 2 hours.
Adjust the infusion rate based on the previous blood glucose, current blood glucose and current infusion rate.
Stop insulin infusion if blood glucose <= 3.8 mmol/L and initiate hypoglycemia protocol by giving 50 mL of 50% Dextrose, calling physician and checking blood glucose every 15 minutes until above 3.8 mg/dL.
Notify physician if insulin infusion is >15 units/hour or blood glucose is > 9 mmol/L.

Initial Insulin Bolus and Dose


Calculator for Insulin Dosing Adjustment