Article (Scientific journals)
Generalisability of a Virtual Trials Method for Glycaemic Control in Intensive Care.
Dickson, Jennifer L.; Stewart, Kent W.; Pretty, Christopher G. et al.
2018In IEEE Transactions on Biomedical Engineering
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Abstract :
[en] BACKGROUND: Elevated blood glucose (BG) concentrations (Hyperglycaemia) are a common complication in critically ill patients. Insulin therapy is commonly used to treat hyperglycaemia, but metabolic variability often results in poor BG control and low BG (hypoglycaemia). OBJECTIVE: This paper presents a model-based virtual trial method for glycaemic control protocol design, and evaluates its generalisability across different populations. METHODS: Model-based insulin sensitivity (SI) was used to create virtual patients from clinical data from three different ICUs in New Zealand, Hungary, and Belgium. Glycaemic results from simulation of virtual patients under their original protocol (self-simulation) and protocols from other units (cross-simulation) were compared. RESULTS: Differences were found between the three cohorts in median SI and inter-patient variability in SI. However, hour-to-hour intra-patient variability in SI was found to be consistent between cohorts. Self and cross-simulation results were found to have overall similarity and consistency, though results may differ in the first 24-48 hours due to different cohort starting BG and underlying SI. CONCLUSIONS AND SIGNIFICANCE: Virtual patients and the virtual trial method were found to be generalisable across different ICUs. This virtual trial method is useful for in silico protocol design and testing, given an understanding of the underlying assumptions and limitations of this method.
Disciplines :
Anesthesia & intensive care
Author, co-author :
Dickson, Jennifer L.
Stewart, Kent W.
Pretty, Christopher G.
Flechet, Marine
Desaive, Thomas  ;  Université de Liège > Département d'astrophys., géophysique et océanographie (AGO) > Thermodynamique des phénomènes irréversibles
Penning, Sophie
LAMBERMONT, Bernard  ;  Centre Hospitalier Universitaire de Liège - CHU > Frais communs médecine - Pool assistants
Benyo, Balazs
Shaw, Geoffrey M.
Chase, Geoff
Language :
English
Title :
Generalisability of a Virtual Trials Method for Glycaemic Control in Intensive Care.
Publication date :
2018
Journal title :
IEEE Transactions on Biomedical Engineering
ISSN :
0018-9294
eISSN :
1558-2531
Publisher :
Institute of Electrical and Electronics Engineers, United States - New York
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 03 August 2017

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