Effect of Insulin Therapy on Traumatic Patients: A Scoping Review

Mehdi Harorani; Behnam Masmouei; Ali Zarei; Fereidoun Jahangiri; Mohammad Rafi Bazrafshan; Zahra Karimi; Mehran  Akbari

doi:10.18502/jimc.v6i2.12229

Mehdi Harorani Department of Nursing, Shazand School of Nursing, Arak University of Medical Sciences, Arak, Iran
Behnam Masmouei Department of Nursing, School of Nursing Hazrat Zahra (P.B.U.H) Abadeh, Shiraz University of Medical Sciences, Shiraz, Iran.
Ali Zarei Department of Physiology, Estahban School of Paramedical Sciences, School of Nursing Hazrat Zahra (P.B.U.H) Abadeh, Shiraz University Of Medical Sciences, Shiraz, Iran
Fereidoun Jahangiri Department of Nursing, School of Nursing Hazrat Zahra (P.B.U.H) Abadeh, Shiraz University of Medical Sciences, Shiraz, Iran
Mohammad Rafi Bazrafshan Department of Nursing, School of Nursing, Larestan University of Medical Sciences, Larestan, Iran
Zahra Karimi Imam Khomeini Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
Mehran Akbari Department of Nursing, School of Nursing, Khomein University of Medical Sciences, Khomein, Iran

DOI: https://doi.org/10.18502/jimc.v6i2.12229

Keywords: Insulin therapy Insulin treatment Injury Multiple traumas Trauma Traumatic patients

Abstract

Background: Trauma is one of the most important causes of death in. Therefore, proper management and treatment of these patients can be very beneficial. Therefore, the aim of this literature was to investigate the extent, scope and nature of researches on the effect of insulin therapy on the treatment efficacy of traumatic patients.
Methods: This study is a scoping review of research that was conducted by searching in Scopus, PubMed, Embase and ScienceDirect databases with keywords related to insulin therapy and trauma. In this study, all reports with human and animals as well as cohort and clinical trial studies were reviewed.
Results: Of the 4365 studies, 73 studies met the inclusion criteria and were evaluated, most studies examining the effect of insulin on traumatic brain injury and immune system and the fewest were in trunk trauma patients, especially chest trauma. The findings of this study showed the effect of insulin therapy on decreasing levels of IL-6, IL-8, IL-10 and TNF-α thus decreasing the inflammatory response in trauma patients. Insulin therapy can reduce the risk of infection in patients with trauma and burns thereby reducing the number of days spent in intensive care units and dependence on ventilation.
Conclusion: Insulin therapy can be useful in treating trauma patients but increases the rate of hypoglycemic episodes that require careful monitoring of patients’ blood glucose which can have a negative impact on treatment outcomes.