Athirah Abdul Razak1, Asma Abu-Samah2, Normy Norfiza Abdul Razak1, Ummu Jamaludin3, Fatanah Suhaimi4, Azrina Ralib5, Mohd Basri Mat Nor6, Christopher Pretty7, Jennifer Laura Knopp7, James Geoffrey Chase7. 1. College of Engineering, Universiti Tenaga Nasional, Kajang, Malaysia. 2. Department of Electrical, Electronics and Systems, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi, Malaysia. 3. Department of Mechanical Engineering, Universiti Malaysia Pahang, Kuantan, Malaysia. 4. Advanced Medical and Dental Institute, Universiti Sains Malaysia, Pulau Pinang, Malaysia. 5. Department of Anesthesiology, International Islamic University Malaysia, Kuantan, Malaysia. 6. Intensive Care Unit, International Islamic University Medical Centre, Kuantan, Malaysia. 7. Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand.
Abstract
PURPOSE: This paper presents an assessment of an automated and personalized stochastic targeted (STAR) glycemic control protocol compliance in Malaysian intensive care unit (ICU) patients to ensure an optimized usage. PATIENTS AND METHODS: STAR proposes 1-3 hours treatment based on individual insulin sensitivity variation and history of blood glucose, insulin, and nutrition. A total of 136 patients recorded data from STAR pilot trial in Malaysia (2017-quarter of 2019*) were used in the study to identify the gap between chosen administered insulin and nutrition intervention as recommended by STAR, and the real intervention performed. RESULTS: The results show the percentage of insulin compliance increased from 2017 to first quarter of 2019* and fluctuated in feed administrations. Overall compliance amounted to 98.8% and 97.7% for administered insulin and feed, respectively. There was higher average of 17 blood glucose measurements per day than in other centres that have been using STAR, but longer intervals were selected when recommended. Control safety and performance were similar for all periods showing no obvious correlation to compliance. CONCLUSION: The results indicate that STAR, an automated model-based protocol is positively accepted among the Malaysian ICU clinicians to automate glycemic control and the usage can be extended to other hospitals already. Performance could be improved with several propositions.
PURPOSE: This paper presents an assessment of an automated and personalized stochastic targeted (STAR) glycemic control protocol compliance in Malaysian intensive care unit (ICU) patients to ensure an optimized usage. PATIENTS AND METHODS: STAR proposes 1-3 hours treatment based on individual insulin sensitivity variation and history of blood glucose, insulin, and nutrition. A total of 136 patients recorded data from STAR pilot trial in Malaysia (2017-quarter of 2019*) were used in the study to identify the gap between chosen administered insulin and nutrition intervention as recommended by STAR, and the real intervention performed. RESULTS: The results show the percentage of insulin compliance increased from 2017 to first quarter of 2019* and fluctuated in feed administrations. Overall compliance amounted to 98.8% and 97.7% for administered insulin and feed, respectively. There was higher average of 17 blood glucose measurements per day than in other centres that have been using STAR, but longer intervals were selected when recommended. Control safety and performance were similar for all periods showing no obvious correlation to compliance. CONCLUSION: The results indicate that STAR, an automated model-based protocol is positively accepted among the Malaysian ICU clinicians to automate glycemic control and the usage can be extended to other hospitals already. Performance could be improved with several propositions.
Authors: G van den Berghe; P Wouters; F Weekers; C Verwaest; F Bruyninckx; M Schetz; D Vlasselaers; P Ferdinande; P Lauwers; R Bouillon Journal: N Engl J Med Date: 2001-11-08 Impact factor: 91.245
Authors: Jean-Charles Preiser; J Geoffrey Chase; Roman Hovorka; Jeffrey I Joseph; James S Krinsley; Christophe De Block; Thomas Desaive; Luc Foubert; Pierre Kalfon; Ulrike Pielmeier; Tom Van Herpe; Jan Wernerman Journal: J Diabetes Sci Technol Date: 2016-11-01
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