Development of Blood Glucose Control for Extremely Premature Infants

Type of content
Journal Article
Thesis discipline
Degree name
Publisher
University of Canterbury. Mechanical Engineering
Journal Title
Journal ISSN
Volume Title
Language
Date
2011
Authors
Le Compte, A.J.
Chase, Geoff
Lynn, A.
Hann, C.E.
Shaw, Geoff
Lin, J.
Abstract

Extremely premature neonates often experience hyperglycaemia, which has been linked to increased mortality and worsened outcomes. Insulin therapy can assist in controlling blood glucose levels and promoting needed growth. This study presents the development of a model-based stochastic targeted controller designed to adapt insulin infusion rates to match the unique and changing metabolic state and control parameters of the neonate. Long-term usage of targeted BG control requires successfully forecasting variations in neonatal metabolic state, accounting for differences in clinical practices between units, and demonstrating robustness to errors that can occur in everyday clinical usage. Simulation studies were used to evaluate controller ability to target several common BG ranges and evaluate controller sensitivity to missed BG measurements and delays in control interventions on a virtual patient cohort of 25 infants developed from retrospective data. Initial clinical pilot trials indicated model performance matched expected performance from simulations. Stochastic targeted glucose control developed using validated patient-specific virtual trials can yield effective protocols for this cohort. Long-term trials show fundamental success, however clinical interface design appears as a critical factor to ensuring good compliance and thus good control.

Description
Citation
LeCompte, A.J., Chase, J.G., Lynn, A., Hann, C.E., Shaw, G.M., Lin, J. (2011) Development of Blood Glucose Control for Extremely Premature Infants. Computer Methods and Programs in Biomedicine, 102(2), pp. 181-191.
Keywords
Glucose, simulation, insulin, control, real-time, neonate, user interface.
Ngā upoko tukutuku/Māori subject headings
ANZSRC fields of research
Fields of Research::32 - Biomedical and clinical sciences::3202 - Clinical sciences::320212 - Intensive care
Fields of Research::32 - Biomedical and clinical sciences::3202 - Clinical sciences::320208 - Endocrinology
Fields of Research::32 - Biomedical and clinical sciences::3201 - Cardiovascular medicine and haematology::320102 - Haematology
Fields of Research::40 - Engineering::4003 - Biomedical engineering::400303 - Biomechanical engineering
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