tailieunhanh - Báo cáo hóa học: " Pilot proof of concept clinical trials of Stochastic Targeted (STAR) glycemic control"

Tuyển tập các báo cáo nghiên cứu về hóa học được đăng trên tạp chí hóa hoc quốc tế đề tài : Pilot proof of concept clinical trials of Stochastic Targeted (STAR) glycemic control | Evans et al. Annals of Intensive Care 2011 1 38 http content 1 1 38 Ù Annals of Intensive Care a SpringerOpen Journal RESEARCH Open Access Pilot proof of concept clinical trials of Stochastic Targeted STAR glycemic control Alicia Evans1 Geoffrey M Shaw2 Aaron Le Compte1 Chia-Siong Tan1 Logan Ward1 James Steel1 Christopher G Pretty1 Leesa Pfeifer2 Sophie Penning3 Fatanah Suhaimi1 Matthew Signal1 Thomas Desaive3 and J Geoffrey Chase1 Abstract Introduction Tight glycemic control TGC has shown benefits but has been difficult to achieve consistently. STAR Stochastic TARgeted is a flexible model-based TGC approach directly accounting for intra- and inter- patient variability with a stochastically derived maximum 5 risk of blood glucose BG mmol L. This research assesses the safety efficacy and clinical burden of a STAR TGC controller modulating both insulin and nutrition inputs in pilot trials. Methods Seven patients covering 660 hours. Insulin and nutrition interventions are given 1-3 hourly as chosen by the nurse to allow them to manage workload. Interventions are calculated by using clinically validated computer models of human metabolism and its variability in critical illness to maximize the overlap of the model-predicted 5-95th percentile range of BG outcomes with the mmol L band while ensuring a maximum 5 risk of BG mmol L. Carbohydrate intake all sources was selected to maximize intake up to 100 of SCCM ACCP goal 25 kg kcal h . Maximum insulin doses and dose changes were limited for safety. Measurements were made with glucometers. Results are compared to those for the SPRINT study which reduced mortality 25-40 for length of stay 3 days. Written informed consent was obtained for all patients and approval was granted by the NZ Upper South A Regional Ethics Committee. Results A total of 402 measurements were taken over 660 hours 14 day because nurses showed a preference for 2-hourly measurements. Median interquartile .