Glucose Control in the Intensive Care Unit: Controller Design and Alarm Layer Performance Evaluation in silico

摘要

As a result of serious injury or disease, patients admitted to critical care units often present with elevated blood glucose levels, a condition commonly referred to as stress hyperglycemia1,2,3. It has been shown3 that a reduction in hyperglycemia through the use of intensive insulin administration to achieve tight glucose control (80-130 mg/dL) may have the potential to significantly reduce morbidity and mortality. However, special care must be taken to avoid hypogylcemia, as even a single hypoglycemic event has the capacity to eliminate any benefit of targeted glucose control (TGC)4,5. The careful balance between hyperglycemia reduction and hypoglycemia prevention that must be struck in a clinical setting requires careful and frequent measurement of blood glucose levels at a rate that quickly becomes burdensome on clinical staff and is untenable in a long-term, large-scale deployment.