PURPOSE: To evaluate the feasibility of developing, refining, and exporting an adequately explicit decision-support tool that standardizes clinician decision-making. To link the activities of disparate clinical research networks.
METHODS: We convened a group of 27 intensive care unit (ICU) sites, half pediatric and half adult, in 3 countries on 2 continents. We developed and refined a bedside computerized protocol that standardized clinician decisions regarding insulin treatment to control blood sugar (eProtocol-insulin). Members of 3 research networks [the NHLBI Adult Respiratory Distress Syndrome (ARDS) Network, the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network, and the NICHD Collaborative Pediatric Critical Care Research Network (CPCCRN)] attend each other's meetings and collaborated.
RESULTS: eProtocol-insulin was initially developed and validated at LDS Hospital. It was then exported to several adult and pediatric ICUs and further refined. eProtocol-insulin has generated 33,405 patient-tailored therapy instructions (96% accepted) in 802 adult ICU patients and 16,611 patient-tailored instructions (90% accepted) in 222 pediatric ICU patients. Safety was established (about 0.1% blood sugars ≤40 mg/dl). Members of the 3 research networks have attended other network meetings and have participated in common project development and execution.
CONCLUSION: We have successfully developed and distributed a common bedside computerized decision-support tool for blood glucose control (eProtocol-insulin) for adults and children. This tool has bridged the disciplines of Pediatrics and Internal Medicine. We have linked the 3 research networks.
CLINICAL IMPLICATIONS: Electronic tools seem capable of providing replicable methods that link pediatric and adult ICU research.
DISCLOSURE: Alan Morris, None.