BACKGROUND: The aim of this study was to investigate the performance of the enhanced Model Predictive Control (eMPC) algorithm for glycemic control in medical critically ill patients for the whole length of intensive care unit (ICU) stay. METHODS: The trial was designed as a single-center, open, noncontrolled clinical investigation in a nine-bed medical ICU in a tertiary teaching hospital. In 20 patients, blood glucose (BG) was controlled with a laptop-based bedside version of the eMPC. Efficacy was assessed by percentage of time within the target range (4.4-6.1 mM; primary end point), mean BG, and BG sampling interval. Safety was assessed by the number of severe hypoglycemic episodes (<2.2 mM). RESULTS: Twenty patients (69 +/- 11 years old; body mass index, 27.4 +/- 4.5 kg/m(2); APACHE II, 25.5 +/- 5.2) were included for a period of 7.3 days (median; interquartile range, 4.4-10.2 days) in the study. Time within target range was 58.12 +/- 10.05% (mean +/- SD). For all patients with at least 7 days in the ICU, there was no statistically significant difference between the daily mean percentage of times in target range in respect of the averages. Mean arterial BG was 5.8 +/- 0.5 mM, insulin requirement was 101.3 +/- 50.7 IU/day, and mean carbohydrate intake (enteral and parenteral nutrition) was 176.4 +/- 61.9 g/day. Three hypoglycemic episodes occurred in three subjects, corresponding to a rate of 0.02 per treatment day. CONCLUSIONS: In our single-center, noncontrolled study the eMPC algorithm was a safe and reliable method to control BG in critically medical ICU patients for the whole length of ICU stay.
BACKGROUND: The aim of this study was to investigate the performance of the enhanced Model Predictive Control (eMPC) algorithm for glycemic control in medical critically ill patients for the whole length of intensive care unit (ICU) stay. METHODS: The trial was designed as a single-center, open, noncontrolled clinical investigation in a nine-bed medical ICU in a tertiary teaching hospital. In 20 patients, blood glucose (BG) was controlled with a laptop-based bedside version of the eMPC. Efficacy was assessed by percentage of time within the target range (4.4-6.1 mM; primary end point), mean BG, and BG sampling interval. Safety was assessed by the number of severe hypoglycemic episodes (<2.2 mM). RESULTS: Twenty patients (69 +/- 11 years old; body mass index, 27.4 +/- 4.5 kg/m(2); APACHE II, 25.5 +/- 5.2) were included for a period of 7.3 days (median; interquartile range, 4.4-10.2 days) in the study. Time within target range was 58.12 +/- 10.05% (mean +/- SD). For all patients with at least 7 days in the ICU, there was no statistically significant difference between the daily mean percentage of times in target range in respect of the averages. Mean arterial BG was 5.8 +/- 0.5 mM, insulin requirement was 101.3 +/- 50.7 IU/day, and mean carbohydrate intake (enteral and parenteral nutrition) was 176.4 +/- 61.9 g/day. Three hypoglycemic episodes occurred in three subjects, corresponding to a rate of 0.02 per treatment day. CONCLUSIONS: In our single-center, noncontrolled study the eMPC algorithm was a safe and reliable method to control BG in critically medical ICU patients for the whole length of ICU stay.
Authors: Basem B Abdelmalak; Andra E Duncan; Angela Bonilla; Dongsheng Yang; Ivan Parra-Sanchez; Amr Fergany; Samuel A Irefin; Daniel I Sessler Journal: J Clin Anesth Date: 2016-02-02 Impact factor: 9.452
Authors: Joseph El Youssef; Jessica R Castle; Deborah L Branigan; Ryan G Massoud; Matthew E Breen; Peter G Jacobs; B Wayne Bequette; W Kenneth Ward Journal: J Diabetes Sci Technol Date: 2011-11-01
Authors: Karin Amrein; Norman Kachel; Heike Fries; Roman Hovorka; Thomas R Pieber; Johannes Plank; Urs Wenger; Barbara Lienhardt; Marco Maggiorini Journal: BMC Endocr Disord Date: 2014-07-29 Impact factor: 2.763
Authors: J Geoffrey Chase; Thomas Desaive; Julien Bohe; Miriam Cnop; Christophe De Block; Jan Gunst; Roman Hovorka; Pierre Kalfon; James Krinsley; Eric Renard; Jean-Charles Preiser Journal: Crit Care Date: 2018-08-02 Impact factor: 9.097