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Space GlucoseControl system for blood glucose control in intensive care patients--a European multicentre observational study
J. Blaha, B. Barteczko-Grajek, P. Berezowicz, J. Charvat, J. Chvojka, T. Grau, J. Holmgren, U. Jaschinski, P. Kopecky, J. Manak, M. Moehl, J. Paddle, M. Pasculli, J. Petersson, S. Petros, D. Radrizzani, V. Singh, J. Starkopf,
Language English Country England, Great Britain
Document type Clinical Trial, Journal Article, Multicenter Study, Observational Study, Research Support, Non-U.S. Gov't
NLK
BioMedCentral
from 2001-12-01
BioMedCentral Open Access
from 2001
Directory of Open Access Journals
from 2001
Free Medical Journals
from 2001
PubMed Central
from 2001
Europe PubMed Central
from 2001
ProQuest Central
from 2009-01-01
Open Access Digital Library
from 2001-10-01
Open Access Digital Library
from 2001-01-01
Open Access Digital Library
from 2001-01-01
Health & Medicine (ProQuest)
from 2009-01-01
ROAD: Directory of Open Access Scholarly Resources
from 2001
Springer Nature OA/Free Journals
from 2001-12-01
- MeSH
- Insulin administration & dosage MeSH
- Intensive Care Units * MeSH
- Blood Glucose drug effects metabolism MeSH
- Critical Illness therapy MeSH
- Middle Aged MeSH
- Humans MeSH
- Critical Care methods MeSH
- Aged MeSH
- Decision Support Systems, Clinical * instrumentation MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial MeSH
- Multicenter Study MeSH
- Observational Study MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Europe epidemiology MeSH
BACKGROUND: Glycaemia control (GC) remains an important therapeutic goal in critically ill patients. The enhanced Model Predictive Control (eMPC) algorithm, which models the behaviour of blood glucose (BG) and insulin sensitivity in individual ICU patients with variable blood samples, is an effective, clinically proven computer based protocol successfully tested at multiple institutions on medical and surgical patients with different nutritional protocols. eMPC has been integrated into the B.Braun Space GlucoseControl system (SGC), which allows direct data communication between pumps and microprocessor. The present study was undertaken to assess the clinical performance and safety of the SGC for glycaemia control in critically ill patients under routine conditions in different ICU settings and with various nutritional protocols. METHODS: The study endpoints were the percentage of time the BG was within the target range 4.4 - 8.3 mmol.l(-1), the frequency of hypoglycaemic episodes, adherence to the advice of the SGC and BG measurement intervals. BG was monitored, and insulin was given as a continuous infusion according to the advice of the SGC. Nutritional management (enteral, parenteral or both) was carried out at the discretion of each centre. RESULTS: 17 centres from 9 European countries included a total of 508 patients, the median study time was 2.9 (1.9-6.1) days. The median (IQR) time-in-target was 83.0 (68.7-93.1) % of time with the mean proposed measurement interval 2.0 ± 0.5 hours. 99.6% of the SGC advices on insulin infusion rate were accepted by the user. Only 4 episodes (0.01% of all BG measurements) of severe hypoglycaemia <2.2 mmol.l(-1) in 4 patients occurred (0.8%; 95% CI 0.02-1.6%). CONCLUSION: Under routine conditions and under different nutritional protocols the Space GlucoseControl system with integrated eMPC algorithm has exhibited its suitability for glycaemia control in critically ill patients. TRIAL REGISTRATION: ClinicalTrials.gov NCT01523665.
Department of Anaesthesiology and Intensive Care Medicine Capio Hospital Sur Madrid Spain
Department of Anaesthesiology and Intensive Care Medicine County Hospital Ryhov Jönköping Sweden
Department of Anaesthesiology and Intensive Care Medicine Vejle Hospital Vejle Denmark
Department of Anaesthesiology and Intensive Care Tartu University Hospital Tartu Estonia
Department of Anaesthesiology and Intensive Therapy Wroclaw Medical University Wroclaw Poland
Department of Anesthesiology and Intensive Care Legnano Hospital Legnano Italy
Department of Surgical and Intensive Medicine Siena University Hospital Siena Italy
Intensive Care Department Royal Cornwall Hospital Truro UK
Internal Medicine Clinic University Hospital in Motol Prague Czech Republic
References provided by Crossref.org
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- $a Blaha, Jan $u Department of Anaesthesiology and Intensive Medicine, 1st Faculty of Medicine, Charles University and General University Hospital Prague, U Nemocnice 2, 128 08, Prague 2, Czech Republic. jan.blaha@lf1.cuni.cz.
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