High-dose insulin euglycemia therapy (HIET)

HIET insulin dose

Estimate the Engebretsen 2011 high-dose insulin euglycemia therapy (HIET) bolus and continuous-infusion range from body weight for beta-blocker or calcium-channel-blocker poisoning with cardiogenic shock.

LIVE $0.005 USDC GET /api/calc/hiet

Markdown: /docs/hiet.md · Canonical: https://magentlab.com/docs/hiet

Not a medical device. Not a diagnosis, dose, or listing recommendation.

What it computes

When to use

When an agent needs the published 1 U/kg insulin bolus plus 1-10 U/kg/h infusion bounds and must not invent a titration algorithm, a dextrose infusion, a potassium protocol, or DigiFab, glucagon, or calcium as a second formula.

When not to use

Not a prescription. Not a medical device. HIET is described for beta-blocker or calcium-channel-blocker poisoning with cardiogenic shock; this tool does not diagnose shock or decide when to start therapy.
Hypoglycemia and hypokalemia are expected risks of high-dose insulin. magent does not titrate the infusion or choose a dextrose infusion or potassium protocol.
This is the published bolus and infusion range only. It is not DigiFab, glucagon, or calcium as a second formula.

Formula

bolus_u = weight_kg * 1; infusion_start_u_h = weight_kg * 1; infusion_max_u_h = weight_kg * 10

Citation

Title: High-dose insulin therapy in beta-blocker and calcium channel-blocker poisoning
Authors: Engebretsen KM, Kaczmarek KM, Morgan J, Holger JS
Source: Clin Toxicol (Phila). 2011;49(4):277-283
DOI: 10.3109/15563650.2011.582471

Worked example

70 kg HIET bolus and infusion range

Given: weight_kg=70

bolus_u = 70 * 1 = 70.0 U
infusion_start_u_h = 70 * 1 = 70.0 U/h
infusion_max_u_h = 70 * 10 = 700.0 U/h

50 kg HIET bolus and infusion range

Given: weight_kg=50

bolus_u = 50 * 1 = 50.0 U
infusion_start_u_h = 50 * 1 = 50.0 U/h
infusion_max_u_h = 50 * 10 = 500.0 U/h

154 lb HIET bolus and infusion range

Given: weight_lb=154

weight_kg = Params.weight_kg: 154 lb * 0.45359237, rounded to 4 decimals
bolus_u = weight_kg * 1, rounded to 1 decimal
infusion_start_u_h = weight_kg * 1, rounded to 1 decimal
infusion_max_u_h = weight_kg * 10, rounded to 1 decimal

Also searched as

high-dose insulin euglycemia
HIET therapy
insulin euglycemia therapy
beta-blocker insulin
calcium channel blocker insulin
high-dose insulin poisoning
1 U/kg insulin bolus
HIET dose

Try

Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.

/api/calc/hiet?weight_kg=70

Full URL: https://api.magentlab.com/api/calc/hiet?weight_kg=70

Call

Expect HTTP 402 until you retry with PAYMENT-SIGNATURE. Incomplete query params return HTTP 400 before any quote or charge.

curl -i -H "Accept: application/json" "https://api.magentlab.com/api/calc/hiet?weight_kg=70"

Parameters

Name	Type	Required	Description
`weight_kg`	number	optional	Weight in kilograms (1-500). Provide weight_kg or weight_lb.
`weight_lb`	number	optional	Weight in pounds (2-1100). Converted as kg = lb * 0.45359237.

Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

POST /api/calc/hiet Max 25 unit_amount + extra_item_amount * (n - 1) extra $0.002 PREVIEW

1 to 25 items. Each item uses the same keys as the GET query parameters.
POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request (fixture)

{
  "items": [
    {
      "weight_kg": "70"
    },
    {
      "weight_kg": "70"
    }
  ]
}

Open bulk paywall →

Opens a two-item fixture on the API host. Unpaid browsers get the same MetaMask paywall as GET; Pay retries POST with those items.

Example 200 (fixture)

{
  "count": 2,
  "path": "/api/calc/hiet",
  "items": [
    {
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Engebretsen KM, Kaczmarek KM, Morgan J, Holger JS",
        "doi": "10.3109/15563650.2011.582471",
        "id": "engebretsen-2011",
        "pmid": "21563902",
        "source": "Clin Toxicol (Phila). 2011;49(4):277-283",
        "title": "High-dose insulin therapy in beta-blocker and calcium channel-blocker poisoning"
      },
      "formula": "hiet",
      "formula_expression": "bolus_u = weight_kg * 1; infusion_start_u_h = weight_kg * 1; infusion_max_u_h = weight_kg * 10",
      "weight_kg": 70.0,
      "bolus_u": 70.0,
      "infusion_max_u_h": 700.0,
      "infusion_start_u_h": 70.0
    },
    {
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Engebretsen KM, Kaczmarek KM, Morgan J, Holger JS",
        "doi": "10.3109/15563650.2011.582471",
        "id": "engebretsen-2011",
        "pmid": "21563902",
        "source": "Clin Toxicol (Phila). 2011;49(4):277-283",
        "title": "High-dose insulin therapy in beta-blocker and calcium channel-blocker poisoning"
      },
      "formula": "hiet",
      "formula_expression": "bolus_u = weight_kg * 1; infusion_start_u_h = weight_kg * 1; infusion_max_u_h = weight_kg * 10",
      "weight_kg": 70.0,
      "bolus_u": 70.0,
      "infusion_max_u_h": 700.0,
      "infusion_start_u_h": 70.0
    }
  ]
}

Response

Field	Type	Description
`formula`	string	hiet
`formula_expression`	string	Exact expression used
`weight_kg`	number	Normalized weight in kg
`bolus_u`	number	Insulin bolus in units (1 U/kg), 1 decimal
`infusion_start_u_h`	number	Starting continuous infusion in U/h (1 U/kg/h), 1 decimal
`infusion_max_u_h`	number	Published upper-bound infusion in U/h (10 U/kg/h), 1 decimal
`citation`	object	Engebretsen et al. 2011 citation
`disclaimer`	string	Not-a-device notice

Example JSON

Machine form of the same example. Frozen fixture. Not a live lookup.

{
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Engebretsen KM, Kaczmarek KM, Morgan J, Holger JS",
    "doi": "10.3109/15563650.2011.582471",
    "id": "engebretsen-2011",
    "pmid": "21563902",
    "source": "Clin Toxicol (Phila). 2011;49(4):277-283",
    "title": "High-dose insulin therapy in beta-blocker and calcium channel-blocker poisoning"
  },
  "formula": "hiet",
  "formula_expression": "bolus_u = weight_kg * 1; infusion_start_u_h = weight_kg * 1; infusion_max_u_h = weight_kg * 10",
  "weight_kg": 70.0,
  "bolus_u": 70.0,
  "infusion_max_u_h": 700.0,
  "infusion_start_u_h": 70.0
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

HTTP	Code	When
400	`invalid_weight`	weight_kg (1-500) or weight_lb (2-1100) is required Returned before settlement; you are not charged.
400	`invalid_items`	POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
400	`invalid_item_count`	items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
400	`invalid_item`	each items entry must be a JSON object Returned before settlement; you are not charged.

Related tools

Levothyroxine dose — Estimate an adult full-replacement daily levothyroxine (LT4) dose from body weight using the ATA 2014 average of approximately 1.6 μg/kg per day.
Phenytoin correction — Estimate an albumin-adjusted total-equivalent phenytoin concentration from observed total phenytoin and albumin, with an optional renal binding-factor change.

Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. Unpaid valid requests return HTTP 402 with a base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote: retry the same PAYMENT-SIGNATURE. Full handshake and shared payment errors: Payments. Stdio MCP: /docs/mcp.

Guarantees

HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
Execution is timeout-bounded and concurrency-capped.
Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.