University of Canterbury Home
    • Admin
    UC Research Repository
    UC Library
    JavaScript is disabled for your browser. Some features of this site may not work without it.
    View Item 
    1. UC Home
    2. Library
    3. UC Research Repository
    4. Faculty of Engineering | Te Kaupeka Pūhanga
    5. Engineering: Journal Articles
    6. View Item
    1. UC Home
    2.  > 
    3. Library
    4.  > 
    5. UC Research Repository
    6.  > 
    7. Faculty of Engineering | Te Kaupeka Pūhanga
    8.  > 
    9. Engineering: Journal Articles
    10.  > 
    11. View Item

    Model-Based Insulin and Nutrition Administration for Tight Glycaemic Control in Critical Care (2007)

    Thumbnail
    View/Open
    12606218_CDD_Revised.pdf (746.8Kb)
    Type of Content
    Journal Article
    UC Permalink
    http://hdl.handle.net/10092/1735
    
    Publisher
    University of Canterbury. Mechanical Engineering.
    ISSN
    1567-2018
    Collections
    • Engineering: Journal Articles [1635]
    Authors
    Chase, Geoff cc
    Shaw, Geoff cc
    Lotz, T.
    LeCompte, A.
    Wong, J.
    Lin, J.
    Lonergan, T.
    Willacy, M.
    Hann, C.E.
    show all
    Abstract

    Objective: Present a new model-based tight glycaemic control approach using variable insulin and nutrition administration.

    Background: Hyperglycaemia is prevalent in critical care. Current published protocols use insulin alone to reduce blood glucose levels, require significant added clinical effort, and provide highly variable results. None directly address both the practical clinical difficulties and significant patient variation seen in general critical care, while also providing tight control.

    Methods: The approach presented manages both nutritional inputs and exogenous insulin infusions using tables simplified from a model-based, computerised protocol. Unique delivery aspects include bolus insulin delivery for safety and variable enteral nutrition rates. Unique development aspects include the use of simulated virtual patient trials created from retrospective data. The model, protocol de-velopment, and first 50 clinical case results are presented.

    Results: High qualitative correlation to within +/-10% between simulated virtual trials and published clinical results validates the overall approach. Pilot tests covering 7358 patient hours produced an average glucose of 5.9 +/- 1.1 mmol/L. Time in the 4-6.1 mmol/L band was 59%, with 84% in 4.0-7.0 mmol/L, and 92% in 4.0-7.75 mmol/L. The average feed rate was 63% of patient specific goal feed and the average insulin dose was 2.6U/hour. There was one hypoglycaemic measurement of 2.1 mmol/L. No departures from protocol or clinical interventions were required at any time.

    Summary: Modulating both low dose insulin boluses and nutrition input rates challenges the current practice of using only insulin in larger doses to reduce hyperglycaemic levels. Clinical results show very tight control in safe glycaemic bands. The approach could be readily adopted in any typical ICU.

    Citation
    Chase, J.G., Shaw, G.M., Lotz, T., LeCompte, A., Wong, J., Lin, J., Lonergan, T., Willacy, M., Hann, C.E. (2007) Model-Based Insulin and Nutrition Administration for Tight Glycaemic Control in Critical Care. Current Drug Delivery (CDD), 4(4), pp. 283-296.
    This citation is automatically generated and may be unreliable. Use as a guide only.
    Rights
    https://hdl.handle.net/10092/17651

    Related items

    Showing items related by title, author, creator and subject.

    • Insulin + nutrition control for tight critical care glycaemic regulation 

      Chase, Geoff; Wong, J.; Lin, J.; LeCompte, A.; Lotz, T.; Lonergan, T.; Willacy, M.B.; Hann, C.E.; Shaw, Geoff (University of Canterbury. Mathematics and Statistics.University of Canterbury. Mechanical Engineering., 2006)
      A new insulin and nutrition control method for tight glycaemic control in critical care is presented from concept to clinical trials to clinical practice change. The primary results show that the method can provide very ...
    • Tight Glycaemic Control in Critical Care Using Insulin and Nutrition - the SPRINT Protocol 

      Chase, Geoff; Shaw, Geoff; LeCompte, A.; Lee, D.; Lonergan, T.; Willacy, M.; Wong, X-W.; Lin, J.; Lotz, T.; Hann, C. (University of Canterbury. Mathematics and Statistics.University of Canterbury. Mechanical Engineering., 2006)
    • Tight glycaemic control with a variable insulin in nutrition protocol 

      Shaw, Geoff; Chase, Geoff; Wong, X.W.; Lin, J.; Lotz, T.; LeCompte, A.; Lonergan, T.; Willacy, M.; Hann, C.E. (University of Canterbury. Mechanical Engineering., 2006)
      The overall approach of modulating insulin and nutrition challenges the current practice of using only insulin to reduce glycaemic levels, which often results in large variability and poor control. The results show ...
    Advanced Search

    Browse

    All of the RepositoryCommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsThesis DisciplineThis CollectionBy Issue DateAuthorsTitlesSubjectsThesis Discipline

    Statistics

    View Usage Statistics
    • SUBMISSIONS
    • Research Outputs
    • UC Theses
    • CONTACTS
    • Send Feedback
    • +64 3 369 3853
    • ucresearchrepository@canterbury.ac.nz
    • ABOUT
    • UC Research Repository Guide
    • Copyright and Disclaimer
    • SUBMISSIONS
    • Research Outputs
    • UC Theses
    • CONTACTS
    • Send Feedback
    • +64 3 369 3853
    • ucresearchrepository@canterbury.ac.nz
    • ABOUT
    • UC Research Repository Guide
    • Copyright and Disclaimer