# High-dose insulin euglycemia therapy (HIET) HIET insulin dose Status: LIVE Price: $0.005 USDC `GET /api/calc/hiet` HTML: https://magentlab.com/docs/hiet Markdown: https://magentlab.com/docs/hiet.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes 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. ## 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 [High-dose insulin therapy in beta-blocker and calcium channel-blocker poisoning](https://doi.org/10.3109/15563650.2011.582471) Engebretsen KM, Kaczmarek KM, Morgan J, Holger JS Clin Toxicol (Phila). 2011;49(4):277-283 DOI: [10.3109/15563650.2011.582471](https://doi.org/10.3109/15563650.2011.582471) ## Worked example ### 70 kg HIET bolus and infusion range Given: `weight_kg=70` 1. bolus_u = 70 * 1 = 70.0 U 2. infusion_start_u_h = 70 * 1 = 70.0 U/h 3. infusion_max_u_h = 70 * 10 = 700.0 U/h ### 50 kg HIET bolus and infusion range Given: `weight_kg=50` 1. bolus_u = 50 * 1 = 50.0 U 2. infusion_start_u_h = 50 * 1 = 50.0 U/h 3. infusion_max_u_h = 50 * 10 = 500.0 U/h ### 154 lb HIET bolus and infusion range Given: `weight_lb=154` 1. weight_kg = Params.weight_kg: 154 lb * 0.45359237, rounded to 4 decimals 2. bolus_u = weight_kg * 1, rounded to 1 decimal 3. infusion_start_u_h = weight_kg * 1, rounded to 1 decimal 4. 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 ## Parameters - `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. Method: `POST /api/calc/hiet` Max items: 25 Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic) Status: 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: ```json { "items": [ { "weight_kg": "70" }, { "weight_kg": "70" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/hiet Example 200: ```json { "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 fields - `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 Frozen fixture. Not a live lookup. ```json { "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 } ``` ## Errors - HTTP 400 `invalid_weight`: weight_kg (1-500) or weight_lb (2-1100) is required Returned before settlement; you are not charged. - HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged. - HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged. - HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged. Shared HTTP 402 and 503: https://magentlab.com/docs/payments ## Related tools - [Levothyroxine dose](https://magentlab.com/docs/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](https://magentlab.com/docs/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. - GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall). - HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote. - Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering. - Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional. - Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402. - offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront. - offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization. - not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search. Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers). Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments Stdio MCP (one process per host): https://magentlab.com/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.