Model-based glycemic control in a Malaysian intensive care unit: performance and safety study

Asma Abu-Samah,1 Jennifer Launa Knopp,2 Normy Norfiza Abdul Razak,3 Athirah Abdul Razak,3 Ummu Kulthum Jamaludin,3 Fatanah Mohamad Suhaimi,4 Azrina Md Ralib,5 Mohd Basri Mat Nor,6 James Geoffrey Chase,2 Christopher Grant Pretty21Institute of Energy Infrastructure, Universiti Tenaga Nasional, Kajang,...

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Autores principales:	Abu-Samah A, Knopp JL, Abdul Razak NN, Razak AA, Jamaludin UK, Mohamad Suhaimi F, Md Ralib A, Mat Nor MB, Chase JG, Pretty CG
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	Glycemic control Intensive care unit Model-based control Pilot trial Malaysian hospital Medical technology R855-855.5
Acceso en línea:	https://doaj.org/article/b30cf322370d4e62a31ad3d4c7d83503
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spelling	oai:doaj.org-article:b30cf322370d4e62a31ad3d4c7d835032021-12-02T03:41:21ZModel-based glycemic control in a Malaysian intensive care unit: performance and safety study1179-1470https://doaj.org/article/b30cf322370d4e62a31ad3d4c7d835032019-05-01T00:00:00Zhttps://www.dovepress.com/model-based-glycemic-control-in-a-malaysian-intensive-care-unit-perfor-peer-reviewed-article-MDERhttps://doaj.org/toc/1179-1470Asma Abu-Samah,1 Jennifer Launa Knopp,2 Normy Norfiza Abdul Razak,3 Athirah Abdul Razak,3 Ummu Kulthum Jamaludin,3 Fatanah Mohamad Suhaimi,4 Azrina Md Ralib,5 Mohd Basri Mat Nor,6 James Geoffrey Chase,2 Christopher Grant Pretty21Institute of Energy Infrastructure, Universiti Tenaga Nasional, Kajang, 43000, Malaysia; 2Department of Mechanical Engineering, University of Canterbury, Christchurch, 8041, New Zealand; 3College of Engineering, Universiti Tenaga Nasional, Kajang, 43000, Malaysia; 4Faculty of Mechanical Engineering, Universiti Malaysia Pahang, Pekan, 26600, Malaysia; 5Advanced Medical and Dental Institute, Universiti Sains Islam Malaysia, Kepala Batas, 13200, Malaysia; 6Kulliyah of Medicine, International Islamic University Malaysia, Kuantan, 25200, MalaysiaBackground: Stress-induced hyperglycemia is common in critically ill patients. A few forms of model-based glycemic control have been introduced to reduce this phenomena and among them is the automated STAR protocol which has been used in the Christchurch and Gyulá hospitals’ intensive care units (ICUs) since 2010.Methods: This article presents the pilot trial assessment of STAR protocol which has been implemented in the International Islamic University Malaysia Medical Centre (IIUMMC) Hospital ICU since December 2017. One hundred and forty-two patients who received STAR treatment for more than 20 hours were used in the assessment. The initial results are presented to discuss the ability to adopt and adapt the model-based control framework in a Malaysian environment by analyzing its performance and safety.Results: Overall, 60.7% of blood glucose measurements were in the target band. Only 0.78% and 0.02% of cohort measurements were below 4.0 mmol/L and 2.2 mmol/L (the limitsfor mild and severe hypoglycemia, respectively). Treatment preference-wise, the clinical staff were favorable of longer intervention options when available. However, 1 hourly treatments were still used in 73.7% of cases.Conclusion: The protocol succeeded in achieving patient-specific glycemic control while maintaining safety and was trusted by nurses to reduce workload. Its lower performance results, however, give the indication for modification in some of the control settings to better fit the Malaysian environment.Keywords: glycemic control, intensive care unit, model-based control, pilot trial, Malaysian hospitalAbu-Samah AKnopp JLAbdul Razak NNRazak AAJamaludin UKMohamad Suhaimi FMd Ralib AMat Nor MBChase JGPretty CGDove Medical PressarticleGlycemic controlIntensive care unitModel-based controlPilot trialMalaysian hospitalMedical technologyR855-855.5ENMedical Devices: Evidence and Research, Vol Volume 12, Pp 215-226 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Glycemic control Intensive care unit Model-based control Pilot trial Malaysian hospital Medical technology R855-855.5
spellingShingle	Glycemic control Intensive care unit Model-based control Pilot trial Malaysian hospital Medical technology R855-855.5 Abu-Samah A Knopp JL Abdul Razak NN Razak AA Jamaludin UK Mohamad Suhaimi F Md Ralib A Mat Nor MB Chase JG Pretty CG Model-based glycemic control in a Malaysian intensive care unit: performance and safety study
description	Asma Abu-Samah,1 Jennifer Launa Knopp,2 Normy Norfiza Abdul Razak,3 Athirah Abdul Razak,3 Ummu Kulthum Jamaludin,3 Fatanah Mohamad Suhaimi,4 Azrina Md Ralib,5 Mohd Basri Mat Nor,6 James Geoffrey Chase,2 Christopher Grant Pretty21Institute of Energy Infrastructure, Universiti Tenaga Nasional, Kajang, 43000, Malaysia; 2Department of Mechanical Engineering, University of Canterbury, Christchurch, 8041, New Zealand; 3College of Engineering, Universiti Tenaga Nasional, Kajang, 43000, Malaysia; 4Faculty of Mechanical Engineering, Universiti Malaysia Pahang, Pekan, 26600, Malaysia; 5Advanced Medical and Dental Institute, Universiti Sains Islam Malaysia, Kepala Batas, 13200, Malaysia; 6Kulliyah of Medicine, International Islamic University Malaysia, Kuantan, 25200, MalaysiaBackground: Stress-induced hyperglycemia is common in critically ill patients. A few forms of model-based glycemic control have been introduced to reduce this phenomena and among them is the automated STAR protocol which has been used in the Christchurch and Gyulá hospitals’ intensive care units (ICUs) since 2010.Methods: This article presents the pilot trial assessment of STAR protocol which has been implemented in the International Islamic University Malaysia Medical Centre (IIUMMC) Hospital ICU since December 2017. One hundred and forty-two patients who received STAR treatment for more than 20 hours were used in the assessment. The initial results are presented to discuss the ability to adopt and adapt the model-based control framework in a Malaysian environment by analyzing its performance and safety.Results: Overall, 60.7% of blood glucose measurements were in the target band. Only 0.78% and 0.02% of cohort measurements were below 4.0 mmol/L and 2.2 mmol/L (the limitsfor mild and severe hypoglycemia, respectively). Treatment preference-wise, the clinical staff were favorable of longer intervention options when available. However, 1 hourly treatments were still used in 73.7% of cases.Conclusion: The protocol succeeded in achieving patient-specific glycemic control while maintaining safety and was trusted by nurses to reduce workload. Its lower performance results, however, give the indication for modification in some of the control settings to better fit the Malaysian environment.Keywords: glycemic control, intensive care unit, model-based control, pilot trial, Malaysian hospital
format	article
author	Abu-Samah A Knopp JL Abdul Razak NN Razak AA Jamaludin UK Mohamad Suhaimi F Md Ralib A Mat Nor MB Chase JG Pretty CG
author_facet	Abu-Samah A Knopp JL Abdul Razak NN Razak AA Jamaludin UK Mohamad Suhaimi F Md Ralib A Mat Nor MB Chase JG Pretty CG
author_sort	Abu-Samah A
title	Model-based glycemic control in a Malaysian intensive care unit: performance and safety study
title_short	Model-based glycemic control in a Malaysian intensive care unit: performance and safety study
title_full	Model-based glycemic control in a Malaysian intensive care unit: performance and safety study
title_fullStr	Model-based glycemic control in a Malaysian intensive care unit: performance and safety study
title_full_unstemmed	Model-based glycemic control in a Malaysian intensive care unit: performance and safety study
title_sort	model-based glycemic control in a malaysian intensive care unit: performance and safety study
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/b30cf322370d4e62a31ad3d4c7d83503
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Model-based glycemic control in a Malaysian intensive care unit: performance and safety study

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