Objective: To evaluate the impact of therapeutic protocol for glycaemia correction in the critically ill. Design: Prospective, intervention study in one centre. Setting: Department of Anaesthesia and Intensive Care, St. Anna’s University Hospital, Brno, Czech Republic. Material and method: Evaluation of glycaemia and insulin therapy during five day test in 8-bed general ICU. Evaluation of compliance with the therapeutic protocol and glycaemic values obtained by two methods (biochemical analyser and glucometer). Results: Nurses followed the protocol in 71 out of 106 relevant cases (compliance 67 %). In case the hyperglycaemia was measured, a significant decrease in glycaemia has been found in the following 6 hour period: from 9.2 (8.0–10.7) to 6.0 (5.0–9.3) mmol/l; P<0.00001. The most significant decrease was measured between the 2nd and 6th hours after an insulin dose change: from 8.0 (6.4–11.2) to 6.0 (5.0–9.3) mmol/l; P<0.01. In case the normoglycaemia (4–6 mmol/l) was measured (n=34), this was present only in 15 (44 %) cases at the following check after 6 hours. Severe hypoglycaemia (< 3 mmol/l) occurred in 5 cases during the study and only 1 of these values was measured with the analyser.The mostfrequentdeviation from the protocol was caused by further correction of insulin dose after one and especially 2 hours after previous insulin dose change. Glycaemia during the study was 6.3 (6.0–8.7) and did not differ from glycaemia measured before and after the study ((7.3 (6.1–9.1) and 6.0 (5.0–8.7) mmol/l, respectively; NS). Arterial blood glucose from analyser was higher by 0.46 ± 1.12 mmol/l compared to capillary blood glucose from glucometer. Conclusion: The implementation of normoglycaemia protocol in the critically ill increases interest in this topic among the ICU staff.Seminars explaining the protocol including its importanceand longer test period are necessary to reach significant therapeutic results.

        Key words: intensive care – care of the critically ill patients – clinical protocols – blood glucose – insulin