Best Practice & Research Clinical Anaesthesiology
Volume 23, Issue 1 , Pages 69-80 , March 2009

Towards closed-loop glycaemic control

  • Tom Van Herpe, PhD (Doctor)

      Affiliations

    • Katholieke Universiteit Leuven, Department of Electrical Engineering (ESAT–SCD), Kasteelpark Arenberg 10, B-3001 Heverlee (Leuven), Belgium
    • Corresponding Author InformationCorresponding author. Tom Van Herpe, SCD Research Division, Electrical Engineering Department (ESAT), Katholieke Universiteit Leuven, Kasteelpark Arenberg 10, B-3001 Leuven-Heverlee, Belgium. Tel: +32 16 328652; Fax: +32 16 321970.
  • ,
  • Bart De Moor, PhD (Professor)

      Affiliations

    • Katholieke Universiteit Leuven, Department of Electrical Engineering (ESAT–SCD), Kasteelpark Arenberg 10, B-3001 Heverlee (Leuven), Belgium
  • ,
  • Greet Van den Berghe, MD, PhD (Professor)

      Affiliations

    • Katholieke Universiteit Leuven, Department of Intensive Care Medicine, Herestraat 49, B-3000 Leuven, Belgium

References 

  1. Van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in the critically ill patients. New England Journal of Medicine. 2001;345:1359–1367
  2. Van den Berghe G, Wilmer A, Hermans G, et al. Intensive insulin therapy in the medical ICU. New England Journal of Medicine. 2006;354:449–461
  3. Mackenzie I, Ingle S, Zaidi S, Buczaski S. Tight glycaemic control: a survey of intensive care practice in large English hospitals. Intensive Care Medicine. 2005;31:1136
  4. Schultz MJ, Spronk PE, Moeniralam HS. Tight glycaemic control: a survey of intensive care practice in the Netherlands. Intensive Care Medicine. 2006;32:618–619
  5. Mechanick JI, Handelsman Y, Bloomgarden ZT. Hypoglycaemia in the intensive care unit. Current Opinion in Clinical Nutrition and Metabolic Care. 2007;10:193–196
  6. Schultz MJ, Royakkers AANM, Levi M, et al. Intensive insulin therapy in intensive care: an example of the struggle to implement evidence-based medicine. PLoS Medicine. 2006;3:e456
  7. Van den Berghe G. First do no harm.hypoglycaemia or hyperglycaemia?. Critical Care Medicine. 2006;34:2843–2844
  8. Van den Berghe G. In Textbook of Critical Care Medicine, chapter 18: Hypoglycaemia. 5th edn.. Elsevier–Saunders; 2005;pp 82–86
  9. Chase JG, Shaw GM, Wong XW, et al. Model-based glycaemic control in critical care - A review of the state of the possible. Biomedical Signal Processing and Control. 2006;1:3–21
  10. Hovorka R. Continuous glucose monitoring and closed-loop systems. Diabetic Medicine. 2006;23:1–12
  11. Hovorka R, Wilinska ME, Chassin LJ, Dunger DB. Roadmap to the artificial pancreas. Diabetes Research and Clinical Practice. 2006;74:S178–S182
  12. Klonoff DC. The artificial pancreas: How sweet engineering will solve bitter problems. Journal of Diabetes Science and Technology. 2007;1:72–81
  13. Van Herpe T, De Brabanter J, Beullens M, et al. Glycemic Penalty Index for adequately assessing and comparing different blood glucose control algorithms. Critical Care. 2008;12:R24
  14. de Graaff MJ, Spronk PE, Schultz MJ. Tight glycaemic control: intelligent technology or a nurse-wise strategy?. Critical Care. 2007;11:421
  15. Turina M, Christ-Crain M, Polk HC. Diabetes and hyperglycaemia: strict glycemic control. Critical Care Medicine. 2006;34:291–300
  16. Morris AH. Developing and implementing computerized protocols for standardization of clinical decisions. Annals of Internal Medicine. 2000;132:373–383
  17. Meijering S, Corstjens AM, Tulleken JE, et al. Towards a feasible algorithm for tight glycaemic control in critically ill patients: a systematic review of the literature. Critical Care. 2006;10:R19
  18. Wilson M, Weinreb J, Hoo GWS. Intensive insulin therapy in critical care: a review of 12 protocols. Diabetes Care. 2007;30:1005–1011
  19. Balkin M, Mascioli C, Smith V, et al. Achieving durable glucose control in the intensive care unit without hypoglycaemia: a new practical IV insulin protocol. Diabetes/Metabolism Research and Reviews. 2007;23:49–55
  20. Chee F, Fernando T, van Heerden PV. Closed-loop control of blood glucose levels in critically ill patients. Anaesthesia and Intensive Care. 2002;30:295–307
  21. Chee F, Fernando T, van Heerden PV. Closed-loop glucose control in critically ill patients using continuous glucose monitoring system (CGMS) in real time. IEEE Transactions on Information Technology in Biomedicine. 2003;7:43–53
  22. Taylor BE, Schallom ME, Sona CS, et al. Efficacy and safety of an insulin infusion protocol in a surgical ICU. Journal of the American College of Surgeons. 2006;202:1–9
  23. Goldberg PA, Sakharova OV, Barrett PW, et al. Improving glycemic control in the cardiothoracic intensive care unit: clinical experience in two hospital settings. Journal of Cardiothoracic and Vascular Anesthesia. 2004;18:690–697
  24. Goldberg PA, Siegel MD, Sherwin RS, et al. Implementation of a safe and effective insulin infusion protocol in a medical intensive care unit. Diabetes Care. 2004;27:461–467
  25. Chant C, Wilson G, Friedrich JO. Validation of an insulin infusion nomogram for intensive glucose control in critically ill patients. Pharmacotherapy. 2005;25:352–359
  26. Kanji S, Singh A, Tierney M, et al. Standardization of intravenous insulin therapy improves the efficiency and safety of blood glucose control in critically ill adults. Intensive Care Medicine. 2004;30:804–810
  27. Lonergan T, Compte AL, Willacy M, et al. A pilot study of the SPRINT protocol for tight glycemic control in critically Ill patients. Diabetes Technology & Therapeutics. 2006;8:449–462
  28. Chase JG, Shaw GM, Hann CE, et al. Clinical validation of a model-based glycaemic control design approach and comparison to other clinical protocols. Proceedings of the 28th IEEE EMBS Annual International Conference. 2006;59–62
  29. Chase JG, Shaw GM, Compte AL, et al. Implementation and evaluation of the SPRINT protocol for tight glycaemic control in critically ill patients: a clinical change. Critical Care. 2008;12:R49
  30. Shulman R, Finney SJ, O'sullivan C, et al. Tight glycaemic control: a prospective observational study of a computerized decision-supported intensive insulin therapy protocol. Critical Care. 2007;11:R75
  31. Rood E, Bosman RJ, van der Spoel JI, et al. Use of a computerized guideline for glucose regulation in the intensive care unit improved both guideline adherence and glucose regulation. Journal of the American Medical Informatics Association. 2005;12:172–180
  32. Davidson PC, Steed RD, Bode BW. Glucommander: a computer-directed intravenous insulin system shown to be safe, simple, and effective in 120,618 h of operation. Diabetes Care. 2005;28:2418–2423
  33. Boord JB, Sharifi M, Greevy RA, et al. Computer-based insulin infusion protocol improves glycaemia control over manual protocol. Journal of the American Medical Informatics Association. 2007;14:278–287
  34. Thomas AN, Marchant AE, Ogden MC, Collin S. Implementation of a tight glycaemic control protocol using a web-based insulin dose calculator. Anaesthesia. 2005;60:1093–1100
  35. Meynaar IA, Dawson L, Tangkau PL, et al. Introduction and evaluation of a computerised insulin protocol. Intensive Care Medicine. 2007;33:591–596
  36. Vogelzang M, Zijlstra F, Nijsten MWN. Design and implementation of GRIP: a computerized glucose control system at a surgical intensive care unit. BMC Medical Informatics and Decision Making. 2005;5:38
  37. Morris AH, Orme J, Truwit JD, et al. A replicable method for blood glucose control in critically ill patients. Critical Care Medicine. 2008;36:1787–1795
  38. Chase JG, Shaw GM, Lin J, et al. Adaptive bolus-based targeted glucose regulation of hyperglycaemia in critical care. Medical Engineering & Physics. 2005;27:1–11
  39. Hann CE, Chase JG, Lin J, et al. Integral-based parameter identification for long-term dynamic verification of a glucose-insulin system model. Computer Methods and Programs in Biomedicine. 2005;77:259–270
  40. Wong XW, Singh-Levett I, Hollingsworth LJ, et al. A novel, model-based insulin and nutrition delivery controller for glycemic regulation in critically ill patients. Diabetes Technology & Therapeutics. 2006;8:174–190
  41. Hovorka R, Kremen J, Blaha J, et al. Blood glucose control by a model predictive control algorithm with variable sampling rate versus a routine glucose management protocol in cardiac surgery patients: a randomized controlled trial. Journal of Clinical Endocrinology and Metabolism. 2007;92:2960–2964
  42. Plank J, Blaha J, Cordingley J, et al. Multicentric, randomized, controlled trial to evaluate blood glucose control by the model predictive control algorithm versus routine glucose management protocols in intensive care unit patients. Diabetes Care. 2006;29:271–276
  43. Hovorka R, Canonico V, Chassin LJ, et al. Nonlinear model predictive control of glucose concentration in subjects with type 1 diabetes. Physiological Measurement. 2004;25:905–920
  44. Ligtenberg JJM, Meertens JH, Monteban-Kooistra WE, et al. Multicentric, randomized, controlled trial to evaluate blood glucose control by the model predictive control algorithm versus routine glucose management protocols in intensive care unit patients: Response to Plank et al. Diabetes Care. 2006;29:1987
  45. Van Herpe T, Haverbeke N, Pluymers B, et al. The application of model predictive control to normalize glycaemia of critically ill patients. Proceedings of the European Control Conference 2007;3116–3123.
  46. Haverbeke N, Van Herpe T, Diehl M, et al. Nonlinear model predictive control with moving horizon state and disturbance estimation – application to the normalization of blood glucose in the critically ill. Proceedings of the 17th IFAC World Congress 2008; 9069–9074.
  47. Van Herpe T, Espinoza M, Haverbeke N, et al. Glycaemia prediction in critically ill patients using an adaptive modeling approach. Journal of Diabetes Science and Technology. 2007;1:348–356
  48. Brunkhorst FM, Engel C, Bloos F, et al. Intensive insulin therapy and pentastarch resuscitation in severe sepsis. New England Journal of Medicine. 2008;358:125–139
  49. Preiser JC, Devos P. Clinical experience with tight glucose control by intensive insulin therapy. Critical Care Medicine. 2007;35:S503–507
  50. Vanhorebeek I, Langouche L, Van den Berghe G. Tight blood glucose control with insulin in the ICU: facts and controversies. Chest. 2007;132:268–278
  51. National Institutes of Health . Normoglycaemia in intensive care evaluation and survival using glucose algorithm regulation (NICE-SUGAR study). Available at: http://www.clinicaltrials.gov/ct/show/NCT00220987Accessed August 04, 2008
  52. Krinsley JS. Effect of an intensive glucose management protocol on the mortality of critically ill adult patients. Mayo Clinic Proceedings. 2004;79:992–1000
  53. Reed CC, Stewart RM, Sherman M, et al. Intensive insulin protocol improves glucose control and is associated with a reduction in intensive care unit mortality. Journal of the American College of Surgeons. 2007;204:1048–1054
  54. Mackenzie I, Ingle S, Zaidi S, Buczaski S. Hypoglycaemia? So what!. Intensive Care Medicine. 2006;32:620–621
  55. Vriesendorp TM, DeVries JH, van Santen S, et al. Evaluation of short-term consequences of hypoglycaemia in an intensive care unit. Critical Care Medicine. 2006;34:2714–2718
  56. Vogelzang M, van der Horst ICC, Nijsten MWN. Hyperglycaemic index as a tool to assess glucose control: a retrospective study. Critical Care. 2004;8:122–127
  57. Van den Berghe G, Wilmer A, Milants I, et al. Intensive insulin therapy in mixed medical/surgical intensive care units: benefit versus harm. Diabetes. 2006;55:3151–3159
  58. Roth JM, Bolin B, Baird RW. Evaluation of blood glucose values in critically ill patients before and after implementation of an intensive insulin infusion protocol. Proceedings (Baylor University. Medical Center). 2007;20:237–239
  59. Brunkhorst FM, Wahl HG. Blood glucose measurements in the critically ill: more than just a blood draw. Critical Care. 2006;10:178
  60. Corstjens AM, Ligtenberg JJM, van der Horst ICC, et al. Accuracy and feasibility of point-of-care and continuous blood glucose analysis in critically ill ICU patients. Critical Care. 2006;10:R135
  61. Dungan K, Chapman J, Braithwaite SS, Buse J. Glucose measurement: confounding issues in setting targets for inpatient management. Diabetes Care. 2007;30:403–409
  62. Finkielman JD, Oyen LJ, Afessa B. Agreement between bedside blood and plasma glucose measurement in the ICU setting. Chest. 2005;127:1749–1751
  63. Lacara T, Domagtoy C, Lickliter D, et al. Comparison of point-of-care and laboratory glucose analysis in critically ill patients. American Journal of Critical Care. 2007;16:336–346
  64. Vogelzang M, Zijlstra F, Nijsten MWN. A wise nurse can manage a paper protocol but prefers intelligent technology. Critical Care. 2007;11:423

PII: S1521-6896(08)00059-1

doi: 10.1016/j.bpa.2008.07.003

Best Practice & Research Clinical Anaesthesiology
Volume 23, Issue 1 , Pages 69-80 , March 2009