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Tight Glycemic Control in Intensive Care: From engineering to clinical practice change
Chase, J. G.; Le Compte, A. J.; Evans, A. et al.
2011In 5th European Conference of the International Federation for Medical and Biological Engineering
Peer reviewed
 

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Keywords :
ICU; hypoglycemia; clinical trials; modelling; control systems; glycemic control; TGC
Abstract :
[en] Tight glycemic control (TGC) is prevalent in critical care. Providing safe, effective TGC has proven very difficult to achieve with clinically derived protocols. The prob-lem is exacerbated by extreme patient variability and the need to minimize clinical effort and burden. These ingredients make an ideal scenario for model-based methods to provide opti-mised solutions. This paper presents the development, clinical-ly validated virtual trials optimisation, and initial clinical implementation of a stochastic targeted (STAR) TGC method and framework. It is compared to a prior successful, model-derived, less flexible and dynamic TGC protocol (SPRINT). The use of stochastic models to safely forecast a range of glu-cose outcomes over 1-3 hours ensures better performance, more dynamic use of the range of insulin and nutrition inputs and thus better glycemic performance and safety from hypo-glycemia, the latter of which was reduced by 3.0x times. Hence, the paper presents an overall engineering approach to TGC from engineering models to clinical implementation and ongo-ing clinical practice change.
Disciplines :
Engineering, computing & technology: Multidisciplinary, general & others
Author, co-author :
Chase, J. G.
Le Compte, A. J.
Evans, A.
Ward, L.
Steel, J.
Tan, C. S.
Pretty, C. G.
Penning, Sophie ;  Université de Liège - ULiège > Département d'astrophys., géophysique et océanographie (AGO) > Thermodynamique des phénomènes irréversibles
Desaive, Thomas  ;  Université de Liège - ULiège > Département d'astrophys., géophysique et océanographie (AGO) > Thermodynamique des phénomènes irréversibles
Shaw, G. M.
Language :
English
Title :
Tight Glycemic Control in Intensive Care: From engineering to clinical practice change
Publication date :
2011
Event name :
5th European Conference of the International Federation for Medical and Biological Engineering
Event place :
Budapest, Hungary
Event date :
14-18 September, 2011
By request :
Yes
Audience :
International
Main work title :
5th European Conference of the International Federation for Medical and Biological Engineering
Peer reviewed :
Peer reviewed
Available on ORBi :
since 12 June 2011

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