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Performance of blood glucose management protocols in HTAA intensive care unit

Humaidi, M. Luqman and WM Zulkifly, W Zuhriraihan and Rosly, C. Zafirah and Khalid, Khalijah and Jamaludin, Ummu Kulthum and Md Ralib, Azrina and Mat Nor, Mohd. Basri (2016) Performance of blood glucose management protocols in HTAA intensive care unit. In: 2016 IEEE International Conference on Automatic Control and Intelligent Systems (I2CACIS),, 22 October 2016, Shah Alam.

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Abstract

Abstract—Insulin Infusion Therapy (IIT) has been implemented in Malaysia Intensive Care Unit (ICU) for decades to control blood glucose level (BGL) among critically ill patients. In this study, clinical data of 210 patients treated with IIT-HTAA protocol and the minimum length of stay of 1 day were analysed. BGL, insulin and nutrition inputs were fitted using Intensive Control Insulin Nutrition Glucose (ICING) model to generate the insulin sensitivity numerically by iterative-integral method. The 95% of confidence interval and Kolmogorov-Smirnov test (p<0.05) were used to evaluate the performance of protocol between the Stochastic TARgeted (STAR) and HTAA protocols per cohorts and per patients. Results indicates BG median [with IQR] recorded in STAR protocol for the whole cohort statistics is lower than HTAA Protocol where 7.4 mmol/L [5.7-9.4] and 8.6 mmol/L [6.8-10.9] respectively. STAR is successful in lowering the BGL which can be seen from the % BG > 10.0 mmol/L is 19.7% while 32.8% for HTAA Protocol. The drawback from this positive result is the increment of hypoglycaemic patients (HTAA Protocol: 9; STAR: 36). Thus, STAR is the best solution in controlling the patients’ BG level especially in Malaysian cohort but the enhancement of STAR have to be done to prevent the risk of hypoglycaemia by introducing patient-specific nutrition controller that can be combined with insulin infusion.

Item Type: Conference or Workshop Item (Speech/Talk)
Additional Information: 3934/56708
Uncontrolled Keywords: blood glucose; hypoglycaemia; Insulin Infusion Therapy; Intensive Care Unit; Intensive Control Insulin Nutrition Glucose; Stochastic TARgeted
Subjects: R Medicine > R Medicine (General)
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button): Kulliyyah of Medicine > Department of Anaesthesiology & Intensive Care
Depositing User: Dr Azrina Md Ralib
Date Deposited: 28 Apr 2017 15:30
Last Modified: 17 Oct 2017 11:35
URI: http://irep.iium.edu.my/id/eprint/56708

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