title: Adaptive bolus-based set-point regulation of hyperglycemia in critical care.
abstract: Critically ill patients are often hyperglycemic and extremely diverse in their dynamics. Consequently, fixed protocols and sliding scales can result in error and poor control. A two-compartment glucose-insulin system model that accounts for time-varying insulin sensitivity and endogenous glucose removal, along with two different saturation kinetics is developed and verified in proof-of-concept clinical trials for adaptive control of hyperglycemia. The adaptive control algorithm monitors the physiological status of a critically ill patient, allowing real-time tight glycemic regulation. The bolus-based insulin administration approach is shown to result in safe, targeted stepwise glycemic reduction for three critically ill patients.
authors.affiliation: Department of Mechanical Engineering, University of Canterbury, New Zealand.
authors.forename: J
authors.initials: J
authors.lastname: Lin
authors.forename: J G
authors.initials: JG
authors.lastname: Chase
authors.forename: G M
authors.initials: GM
authors.lastname: Shaw
authors.forename: C V
authors.initials: CV
authors.lastname: Doran
authors.forename: C E
authors.initials: CE
authors.lastname: Hann
authors.forename: M B
authors.initials: MB
authors.lastname: Robertson
authors.forename: P M
authors.initials: PM
authors.lastname: Browne
authors.forename: T
authors.initials: T
authors.lastname: Lotz
authors.forename: G C
authors.initials: GC
authors.lastname: Wake
authors.forename: B
authors.initials: B
authors.lastname: Broughton