The Use of Continuous Glucose Monitoring Combined with Computer-Based eMPC Algorithm for Tight Glucose Control in Cardiosurgical ICU
The Use of Continuous Glucose Monitoring Combined with Computer-Based eMPC Algorithm for Tight Glucose Control in Cardiosurgical ICU
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DOI：
10.1155/2013/186439
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发表时间：
2013-01-01
影响因子：
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通讯作者：
Haluzik, Martin
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文献类型：
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作者：
Kopecky, Petr;Mraz, Milos;Haluzik, Martin
瞄准在心脏手术后患者中，我们使用连续血糖监测（CGM）和增强型模型预测控制（eMPC）算法评估了强化静脉胰岛素治疗系统的性能。方法.比较eMPC-CGM组（n = 12）与对照（C）组（n = 12）的血糖控制情况，对照组仅通过根据eMPC方案调整的静脉胰岛素输注进行治疗，采样间隔可变。在eMPC-CGM组中，使用实时CGM系统（Guardian RT）测量的葡萄糖作为eMPC的输入，每15分钟调整一次胰岛素输注。使用参考动脉血糖和克拉克误差网格分析（C-EGA）每小时评价CGM的准确性。目标血糖范围为4.4- 6.1 mmol/L。结果在277个配对的CGM-参考血糖值中，270个（97.5%）在C-EGA的临床可接受区，仅7个（2.5%）在不可接受的D区。eMPC-CGM组中的葡萄糖控制在所有测量值方面与C组相当（平均值，高于、在和低于目标范围的时间百分比）。无低血糖发作（
Aim. 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. Methods. 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 4.4-6.1mmol/L. Results. 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 (