Decision Support for treatment of critically ill patients in intensive care
Studenteropgave: Speciale (inkl. HD afgangsprojekt)
- Brian Juliussen
4. semester , Sundhedsteknologi (cand.polyt.), Kandidat (Kandidatuddannelse)
Background: Hyperglycaemia is prevalent in critically
ill patients and can increase mortality. This
report presents and validates a glycaemic control
system using a physiologically based metabolic
control model (Glucosafe) and an associated integral
based parameter identification method. The
intended application for this glycaemic control
system, and the associated model and parameter
identification method is glycaemic control of
critically ill patients. Methods: The glycaemic
control system uses the Glucosafe glucose-insulin
metabolic model. Time varying insulin sensivity,
SI , is determined between measurements using
an integral-based method. The glycaemic control
system is validated by its ability to keep patients
in a normoglycaemic range (4.4-7.75 mmol/L).
Clinical control interventions are determined by
optimization over a series of penalty functions.
The system is validated against 20 virtual patients
by using patient specific insulin sensivity
profiles based on clinical data from 20 critical care
patients at Christchurch Hospital (New Zealand).
Results: The overall median blood glucose concentration
for all 20 patients is 6.05 mmol/L, and
the IQR is 5.54-6.62 mmol/L. The overall number
of hypoglycaemic measurements per patient is 0
(blood glucose measurements below 2.2 mmol/L).
The overall mean percent of measurements inside
the normoglycaemic range (4.4-7.75 mmol/L) is
87.7 %. Conclusions: The results for the glycaemic
control validation presented are comparable
to other similar studies by Chase et al. (2008)
and are acceptable for later use in clinical pilot
trials.
Sprog | Engelsk |
---|---|
Udgivelsesdato | 2008 |
Antal sider | 138 |
Udgivende institution | AAU |