Blood glucose model for liver transplantation: Alteration of physiological parameters

摘要

During liver-transplantation (LT) a tight glycemic control protocol can improve the clinical outcomes. The ICING (Intensive-Control-Insulin-Nutrition-Glucose) model is validated for medical intensive care unit (MICU) application. Previous studies have showed that changes in the model parameters are necessary to use it in LT environments. This study analyses the optimal range of physiological parameters and the differences between the MICU and LT cases, as well the time dependency of the parameters after the recirculation of the new liver. There can be found a clear optimal physiological parameter range for the phase before the recirculation of the new liver, the parameter values are different from the MICU patients with higher endogenous glucose production and lower glucose dependent glucose utilization values. After the recirculation there is an approximately 9 hours long time interval where the optimal parameter set cannot be clearly determined. During this transition time the differences gradually disappear between the MICU and LT patients.