The use of continuous glucose monitoring combined with computer-based eMPC algorithm for tight glucose control in cardiosurgical ICU.

In postcardiac surgery patients, we assessed the performance of a system for intensive intravenous insulin therapy using continuous glucose monitoring (CGM) and enhanced model predictive control (eMPC) algorithm.~Aim~Objective~Glucose control in eMPC-CGM group (n = 12) was compared with a control (C...

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Publicado en:BioMed Research International Vol. 2013; pp. 186439 - 186440
Autores principales: Kopecky, Petr, Mráz, Milos, Bláha, Jan, Lindner, Jaroslav, Svacina, Stpán, Hovorka, Roman, Haluzík, Martin
Formato: Journal Article
Publicado: Wiley-Blackwell 2013
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Wiley-Blackwell
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        atl: The use of continuous glucose monitoring combined with computer-based eMPC algorithm for tight glucose control in cardiosurgical ICU.
      aug:
        au:
          Kopecky, Petr
          Mráz, Milos
          Bláha, Jan
          Lindner, Jaroslav
          Svacina, Stpán
          Hovorka, Roman
          Haluzík, Martin
        affil: Department of Anaesthesia, Resuscitation and Intensive Medicine, 1st Faculty of Medicine and General University Hospital, Charles University in Prague, U Nemocnice 2, 128 08 Prague 2, Czech Republic.
      sug:
        subj:
          Blood Glucose Analysis
          Diabetes Mellitus, Type 1 Blood
          Insulin Administration and Dosage
          Aged
          Algorithms
          Diabetes Mellitus, Type 1 Surgery
          Female
          Infusions, Intravenous
          Intensive Care Units
          Male
          Middle Age
          Postoperative Period
          Aged: 65+ years
          Middle Aged: 45-64 years
          Female
          Male
      ab: In postcardiac surgery patients, we assessed the performance of a system for intensive intravenous insulin therapy using continuous glucose monitoring (CGM) and enhanced model predictive control (eMPC) algorithm.~Aim~Objective~Glucose control in eMPC-CGM group (n = 12) was compared with a control (C) group (n = 12) treated by intravenous insulin infusion adjusted according to eMPC protocol with a variable sampling interval alone. In the eMPC-CGM group glucose measured with a REAL-Time CGM system (Guardian RT) served as input for the eMPC adjusting insulin infusion every 15 minutes. The accuracy of CGM was evaluated hourly using reference arterial glucose and Clarke error-grid analysis (C-EGA). Target glucose range was 4.4-6.1¿mmol/L.~Methods~Methods~Of the 277 paired CGM-reference glycemic values, 270 (97.5%) were in clinically acceptable zones of C-EGA and only 7 (2.5%) were in unacceptable D zone. Glucose control in eMPC-CGM group was comparable to C group in all measured values (average glycemia, percentage of time above, within, and below target range,). No episode of hypoglycemia (<2.9 mmol) occurred in eMPC-CGM group compared to 2 in C group.~Results~Results~Our data show that the combination of eMPC algorithm with CGM is reliable and accurate enough to test this approach in a larger study population.~Conclusion~Conclusions
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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