Reference : Insulin Kinetics during Hyper-Insulinemia Euglycemia Therapy (HIET)

	Document type :	Scientific congresses and symposiums : Paper published in a book
	Discipline(s) :	Engineering, computing & technology : Multidisciplinary, general & others
	To cite this reference:	http://hdl.handle.net/2268/131460

Title :	Insulin Kinetics during Hyper-Insulinemia Euglycemia Therapy (HIET)
Language :	English
Author, co-author :	Penning, Sophie [Université de Liège - ULg > Département d'astrophys., géophysique et océanographie (AGO) > Thermodynamique des phénomènes irréversibles >]
	MASSION, Paul [Centre Hospitalier Universitaire de Liège - CHU > > Soins intensifs >]
	Le Compte, Aaron J. []
	Desaive, Thomas [Université de Liège - ULg > Département d'astrophys., géophysique et océanographie (AGO) > Thermodynamique des phénomènes irréversibles >]
	Chase, J. Geoffrey []
Publication date :	Aug-2012
Main document title :	Proceedings of the 8th IFAC Symposium on Biological and Medical Systems
Peer reviewed :	Yes
On invitation :	Yes
Audience :	International
Event name :	8th IFAC Symposium on Biological and Medical Systems
Event date :	29-31 août 2012
Event place (city) :	Budapest
Event country :	Hungary
Abstract :	[en] Hyper-insulinemia euglycemia therapy (HIET) is a supra-physiological insulin dosing protocol used in acute cardiac failure to reduce dependency on inotropes to augment or generate cardiac output, and is based on the inotropic effects of insulin at high doses up to 45-250x normal daily dose. Such high insulin doses are managed using intravenous glucose infusion to control glycemia and prevent hypoglycemia. However, both insulin dosing and glycemic control in these patients is managed ad-hoc. This research examines a selection of clinical data to determine the effect of high insulin dosing on renal clearance and insulin sensitivity, to assess the feasibility of using model-based methods to control and guide these protocols. The results show that the model and, in particular, the modeled renal clearance constant are adequate and capture measured data well, although not perfectly. Equally, insulin sensitivity over time is similar to broader critical care cohorts in level and variability, and these results are the first time they have been presented for this cohort. While more data is needed to confirm and further specify these results, it is clear that the model used is adequate for controlling HIET in a model-based framework.
Funders :	Fonds de la Recherche Scientifique (Communauté française de Belgique) - F.R.S.-FNRS ; Fonds Léon Fredericq
Permalink :	http://hdl.handle.net/2268/131460

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