Closed-loop Control of Blood Glucose Levels in Critically Ill Patients

Anaesthesia and Intensive Care - Tập 30 Số 3 - Trang 295-307 - 2002
F. Chee1, Tyrone Fernando1, Peter Vernon van Heerden2
1Department of Electrical and Electronic Engineering, the University of Western Australia, Perth, W.A.
2Department of Intensive Care, Sir Charles Gairdner Hospital and Department of Pharmacology, the University of Western Australia, Perth, W.A.

Tóm tắt

A closed-loop control system was constructed for automatic intravenous infusion of insulin to control blood sugar levels (BSL) in critically ill patients. We describe the development of the system. A total of nine subjects were recruited to clinically test the control system. In the patients who underwent closed-loop control of BSL, the controller managed to control only one patient's glycaemia without any manual intervention. The average BSL attained during closed-loop control approached the target range of 6-10 mmol/l, and had less deviation than when BSL had been maintained manually.

We conclude that closed-loop BSL control using a sliding scale algorithm is feasible. The main deficiency in the current system is unreliability of the subcutaneous glucose sensor when used in this setting. This deficiency mandates high vigilance during use of the system as it is being developed.

Từ khóa


Tài liệu tham khảo

Pfeiffer E.F., 1987, Diabetologia, 30, 51, 10.1007/BF00274572

10.2337/diacare.21.3.444

10.2337/diab.23.5.397

Clemens A.H., 1977, Horm Metab Res, 8, 23, 10.1159/000178776

Pfeiffer E.F., 1990, Horm Metab Res, 24, 154

10.3109/03091908409018186

10.2337/diacare.13.9.955

10.1055/s-2007-1001763

Pickup J., 1999, MBJ, 139, 1

10.1001/jama.280.4.312-JMN0722-2-1

10.1007/BF02221686

10.1007/BF00404077

10.2337/diacare.17.5.387

10.1007/BF00285330

10.1007/BF00250158

10.2337/diab.33.12.1200

Mastrototaro J.J., 1992, Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 14, 154

Morff R.J., 1990, Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 12, 483

10.1109/51.897829

MiniMed Pty Ltd, MiniMed cgms™ continuous glucose monitoring system User Manual, March 2000.

Welborn T.A., 1997, Churchill Livingstone, Medical Division of Pearson Professional Limited,, 585

Chee F., Trans Inf Technol Biomed

10.2337/diacare.10.5.622

Altman D.G., 1991, Practical statistics for medical research

10.1152/ajpendo.1999.277.3.E561

10.1056/NEJMoa011300