Glucose Control in the ICU

Abstract

In the present era of near-continuous glucose monitoring (CGM) and automated therapeutic closed-loop systems, measures of accuracy and of quality of glucose control need to be standardized for licensing authorities and to enable comparisons across studies and devices. Adequately powered, good quality, randomized, controlled studies are needed to assess the impact of different CGM devices on the quality of glucose control, workload, and costs. The additional effects of continuing glucose control on the general floor after the ICU stay also need to be investigated. Current algorithms need to be adapted and validated for CGM, including effects on glucose variability and workload. Improved collaboration within the industry needs to be encouraged because no single company produces all the necessary components for an automated closed-loop system. Combining glucose measurement with measurement of other variables in 1 sensor may help make this approach more financially viable.

Continuous Glucose Monitoring: A Review of Recent Studies Demonstrating Improved Glycemic Outcomes

“…Usage of CGM in the hospitalized patient and in the ICU remains a work in progress. 49,50 There has been considerable interest in the use of CGM in the hospitalized patient to assist with glycemic control in patients continuing the therapies they used as an outpatient, for control of insulin infusions, and for use in the intensive care unit. The continuing improvement in the accuracy, robustness, and usability of CGM sensors offers considerable promise for an increasing role for the hospitalized patient.…”

Вплив Різних Хірургічних Доступів При Протезуванні Аортального Клапана На Ступінь Вираженості Операційного Стресу І системної Запальної Реакції

“…Незважаючи на відсут-ність статистично значимої різниці, значення р да-них показників наближено до граничного значення 0,05, що вказує на наявність тенденції до підвищен-ня. Дані результати свідчать про наявність стресової гормональної перебудови основного обміну речо-вин у прооперованих пацієнтів у вигляді стресової стимуляції продукції тиреотропного гормона та гі-перглікемії [5,[14][15][16].…”

Closed-loop Administration of General Anaesthesia: From Sensor to Medical Device

“…Simple closed-loops exist in our familiar environment such as central heating machines whose activation is activated/deactivated by room temperature. Adapting therapeutic targets to physiological signals has been applied to several domains of anaesthesia and intensive care: fluid administration [2][3][4], mechanical ventilation [5], general anaesthesia [6][7][8][9], hyperglycemia [10]. General anaesthesia results from the combination of hypnotic and analgesic drugs, sometimes associated to myorelaxants, in order to produce amnesia, analgesia and immobility [11,12].…”