The effects of insulin glucose administration in fulminant hepatic failure

[Metabolism during shock and its therapeutic regulations]

During shock the organism reacts by means of primarily useful autoregulation mechanisms which, however, in excess become useless and at least harmful. Therapeutically it is necessary now, to partly break through these mechanisms going along with substitution of certain necessary substances and besides that in part to support the organism's own concept.

Control of blood glucose during nutritional support in ill patients

The traditional "Sliding Scale" is an inefficient and unreliable way of controlling blood glucose levels in ill patients receiving nutritional support in the Intensive Care Unit. In these patients, it is necessary to reassess insulin requirements frequently in the light of changing clinical circumstances. A significant improvement in control can be achieved by using a dynamic scale of instructions for changing the insulin dose rather than one of arbitrary dose levels. This scale adapts to any changes that occur without needing to be rewritten. It avoids confusion due to a proliferation of prescription charts, and has been readily accepted by nursing staff.