Towards closed-loop glycaemic control.
Blood glucose control performed by intensive care unit (ICU) nurses is becoming standard practice for critically ill patients. New algorithms, ranging from basic protocols to elementary computerized protocols to advanced computerized protocols, have been presented during the last years aiming to reduce the workload of the medical team. This paper gives an overview of the different types of algorithms and their features. Performance comparisons between different algorithms are avoided as blood glucose sampling frequencies and protocol durations were not similar among different studies and even within studies. Particularly advanced computerized protocols can potentially be introduced as fully-automated blood glucose algorithms when accurate and reliable near-continuous glucose sensor devices are available. Furthermore, it is surprising to consider in some of the described protocols that the original blood glucose target ranges (80-110 mg/dl) were increased (due to fear of hypoglycaemia) and/or that glycaemia levels were determined in capillary blood samples.
Van Herpe
Tom
T
Katholieke Universiteit Leuven, Department of Electrical Engineering (ESAT-SCD), Kasteelpark Arenberg 10, B-3001 Heverlee (Leuven), Belgium tom.vanherpe@esat.kuleuven.be
De Moor
Bart
B
Van den Berghe
Greet
G
D000465:Algorithms; D001786:Blood Glucose / Q000032:analysis*; D002985:Clinical Protocols; D003422:Critical Care; D016638:Critical Illness; D020000:Decision Support Systems, Clinical; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D007332:Insulin Infusion Systems; D007362:Intensive Care Units; D008991:Monitoring, Physiologic / Q000295:instrumentation* / Q000379:methods
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin