Efficacy and Safety of Glucose Control with Space GlucoseControl in the Medical Intensive Care Unit—An Open Clinical Investigation

Amrein, Karin; Ellmerer, Martin; Hovorka, Roman; Kachel, Norman; Fries, Heike; Lewinski, Dirk von; Smolle, Karl-Heinz; Pieber, Thomas R.; Plank, Johannes

doi:10.1089/dia.2012.0021

Cited by 26 publications

(28 citation statements)

References 22 publications

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“…Baseline characteristics of the Zurich population (n = 20) are given in Table 1. Baseline characteristics of the Graz population have been reported previously [28] and are similar except for a higher rate of norepinephrine and parenteral nutrition. Because of substantial national differences in informed consent procedure for patients unable to give consent at the time of study inclusion, time from ICU admission to study inclusion was significantly different between the two sites (Graz 1.7 ± 1.5, Zurich 6.7 ± 5.9 days, P = 0.001).…”

Section: Resultsmentioning

confidence: 53%

“…Baseline data of the study population in Graz have been reported previously [28]. There are no significant differences between both populations with the exception of a higher rate of norepinephrine use (90 vs. 55%, P < 0.01) and a higher rate of parenteral nutrition in Graz 85 vs. 30%, P < 0.01.…”

Section: Resultsmentioning

confidence: 62%

“…Detailed information regarding glucose readings and sampling intervals within each center is given in Table 2. Percentages of time per day within blood glucose level ranges with a focus on Zurich data are given in Table 3, the detailed Graz data have been reported previously [28]. Average and individual glucose profiles are displayed in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…The trial was registered at the Clinical Trials Database (ClinicalTrials.gov Identifier: NCT01164423 and NCT01164449). Selected data of the trial in Graz have been published previously [28]. …”

Section: Methodsmentioning

confidence: 99%

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Glucose control in intensive care: usability, efficacy and safety of Space GlucoseControl in two medical European intensive care units

et al. 2014

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BackgroundThe Space GlucoseControl system (SGC) is a nurse-driven, computer-assisted device for glycemic control combining infusion pumps with the enhanced Model Predictive Control algorithm (B. Braun, Melsungen, Germany). We aimed to investigate the performance of the SGC in medical critically ill patients.MethodsTwo open clinical investigations in tertiary centers in Graz, Austria and Zurich, Switzerland were performed. Efficacy was assessed by percentage of time within the target range (4.4-8.3 mmol/L; primary end point), mean blood glucose, and sampling interval. Safety was assessed by the number of hypoglycemic episodes (≤2.2 mmol/L) and the percentage of time spent below this cutoff level. Usability was analyzed with a standardized questionnaire given to involved nursing staff after the trial.ResultsForty medical critically ill patients (age, 62 ± 15 years; body mass index, 30.0 ± 8.9 kg/m2; APACHE II score, 24.8 ± 5.4; 27 males; 8 with diabetes) were included for a period of 6.5 ± 3.7 days (n = 20 in each center). The primary endpoint (time in target range 4.4 to 8.3 mmol/l) was reached in 88.3% ± 9.3 of the time and mean arterial blood glucose was 6.7 ± 0.4 mmol/l. The sampling interval was 2.2 ± 0.4 hours. The mean daily insulin dose was 87.2 ± 64.6 IU. The adherence to the given insulin dose advice was high (98.2%). While the percentage of time spent in a moderately hypoglycemic range (2.2 to 3.3 mmol/L) was low (0.07 ± 0.26% of the time), one severe hypoglycemic episode (<2.2 mmol/L) occurred (2.5% of patients or 0.03% of glucose readings).ConclusionsSGC is a safe and efficient method to control blood glucose in critically ill patients as assessed in two European medical intensive care units.

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Section: Resultsmentioning

confidence: 53%

Section: Resultsmentioning

confidence: 62%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Glucose control in intensive care: usability, efficacy and safety of Space GlucoseControl in two medical European intensive care units

et al. 2014

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“…It has been integrated in the B.Braun Space GlucoseControl (SGC) system, which allows direct data communication between pumps and Space Control with the incorporated eMPC algorithm. Although SGC is already clinically used in dozens of ICUs worldwide, there are few only published experiences with its use [4]. …”

Section: Introductionmentioning

confidence: 99%

Evaluation of blood glucose control in ICU patients with Space GlucoseControl: a European study

Bláha

2014

Crit Care

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Glycemic control in the intensive care unit: A control systems perspective

Chase

Benyó

Desaive

2019

Annual Reviews in Control

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Computers and automation have revolutionised quality and productivity in many industries, but not in medicine. Healthcare costs are thus growing beyond the ability of society to pay for them, multiplied by the impact of increasingly aging populations, and specifically in the demand placed on intensive care unit (ICU) services. Glycemic control is a core ICU therapy with the potential to reduce both mortality and cost, which makes it an area where greater personalisation and automation could play a leading role in improving productivity and care. This review presents the background to the problem and the main issues arising in this area of care from a control systems technology perspective. It then presents a vision of a more automated future with specific goals in the areas of dynamic systems modeling, system identification and control. These areas are then given a state of the art review, mixing both medicine and control systems perspectives. It is concluded by specific recommendations for the field, where control systems expertise can be leveraged to best advantage.

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Efficacy and Safety of Glucose Control with Space GlucoseControl in the Medical Intensive Care Unit—An Open Clinical Investigation

Abstract: SGC is a safe and efficient method to control blood glucose in critically ill patients in the medical intensive care unit.

Cited by 26 publications

References 22 publications

Glucose control in intensive care: usability, efficacy and safety of Space GlucoseControl in two medical European intensive care units

Glucose control in intensive care: usability, efficacy and safety of Space GlucoseControl in two medical European intensive care units

Evaluation of blood glucose control in ICU patients with Space GlucoseControl: a European study

Glycemic control in the intensive care unit: A control systems perspective

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