High-Dose Insulin Euglycemia Therapy Guidelines

Introduction to HDIE Therapy

• The American Heart Association recommends 1 U/kg regular insulin bolus with 0.5 g/kg dextrose, followed by continuous infusions of 0.5-1 U/kg/hr insulin for cardiac arrest in special situations 1

Current Standard Practice

• The Society of Critical Care Medicine recommends HDIE as a first-line treatment with 1 U/kg bolus followed by 1 U/kg/hr infusion, with maintenance of euglycemia and close potassium monitoring 2

Mechanistic Understanding

• High-dose insulin euglycemia therapy has a direct positive inotropic effect on myocardial contractility, as supported by the Society of Critical Care Medicine 2