Brain mass estimation by head circumference and body mass methods in neonatal glycaemic modelling and control (2014)
AuthorsGunn CA, Dickson JL, Pretty CG, Alsweiler JM, Lynn A, Shaw GM, Chase, J.G.show all
Introduction: Hyperglycaemia is a common complication of stress and prematurity in extremely low-birth-weight infants. Model-based insulin therapy protocols have the ability to safely improve glycaemic control for this group. Estimating non-insulin-mediated brain glucose uptake by the central nervous system in these models is typically done using population-based body weight models, which may not be ideal. Method: A head circumference-based model that separately treats small-for-gestational-age (SGA) and appropriate-for-gestational-age (AGA) infants is compared to a body weight model in a retrospective analysis of 48 patients with a median birth weight of 750g and median gestational age of 25 weeks. Estimated brain mass, model-based insulin sensitivity (SI) profiles, and projected glycaemic control outcomes are investigated. SGA infants (5) are also analyzed as a separate cohort. Results: Across the entire cohort, estimated brain mass deviated by a median 10% between models, with a per-patient median difference in SI of 3.5%. For the SGA group, brain mass deviation was 42%, and per-patient SI deviation 13.7%. In virtual trials, 87-93% of recommended insulin rates were equal or slightly reduced (δ<0.16mU/h) under the head circumference method, while glycaemic control outcomes showed little change. Conclusion: The results suggest that body weight methods are not as accurate as head circumference methods. Head circumference-based estimates may offer improved modelling accuracy and a small reduction in insulin administration, particularly for SGA infants. © 2014 Elsevier Ireland Ltd.
CitationGunn CA, Dickson JL, Pretty CG, Alsweiler JM, Lynn A, Shaw GM, Chase JG (2014). Brain mass estimation by head circumference and body mass methods in neonatal glycaemic modelling and control. Computer Methods and Programs in Biomedicine. 115(2). 47-54.
This citation is automatically generated and may be unreliable. Use as a guide only.
ANZSRC Fields of Research11 - Medical and Health Sciences::1114 - Paediatrics and Reproductive Medicine::111401 - Foetal Development and Medicine
11 - Medical and Health Sciences::1103 - Clinical Sciences::110306 - Endocrinology