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

Background: 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 (IC...

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Main Authors: Abu-Samah, Asma, Knopp, Jennifer Launa, Mohamad Suhaimi, Fatanah, Abdul Razak, Athirah, Abdul Razak, Normy Norfiza, Jamaludin, Ummu Kulthum, Md Ralib, Azrina, Mat Nor, Mohd Basri, Chase, Geoffrey, Pretty, Christopher G.
Format: Article
Language:English
Published: Dovepress 2019
Subjects:
Online Access:http://irep.iium.edu.my/72464/
http://irep.iium.edu.my/72464/1/72464_Model-based%20glyceic%20control%20in%20a%20Malaysian.pdf
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author Abu-Samah, Asma
Knopp, Jennifer Launa
Mohamad Suhaimi, Fatanah
Abdul Razak, Athirah
Abdul Razak, Normy Norfiza
Jamaludin, Ummu Kulthum
Md Ralib, Azrina
Mat Nor, Mohd Basri
Chase, Geoffrey
Pretty, Christopher G.
author_facet Abu-Samah, Asma
Knopp, Jennifer Launa
Mohamad Suhaimi, Fatanah
Abdul Razak, Athirah
Abdul Razak, Normy Norfiza
Jamaludin, Ummu Kulthum
Md Ralib, Azrina
Mat Nor, Mohd Basri
Chase, Geoffrey
Pretty, Christopher G.
author_sort Abu-Samah, Asma
building IIUM Repository
collection Online Access
description Background: 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.
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spelling iium-724642020-04-08T16:49:24Z http://irep.iium.edu.my/72464/ Model-based glyceic control in a Malaysian intensive care unit: performance and safety study Abu-Samah, Asma Knopp, Jennifer Launa Mohamad Suhaimi, Fatanah Abdul Razak, Athirah Abdul Razak, Normy Norfiza Jamaludin, Ummu Kulthum Md Ralib, Azrina Mat Nor, Mohd Basri Chase, Geoffrey Pretty, Christopher G. R Medicine (General) Background: 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. Dovepress 2019-05-31 Article PeerReviewed application/pdf en http://irep.iium.edu.my/72464/1/72464_Model-based%20glyceic%20control%20in%20a%20Malaysian.pdf Abu-Samah, Asma and Knopp, Jennifer Launa and Mohamad Suhaimi, Fatanah and Abdul Razak, Athirah and Abdul Razak, Normy Norfiza and Jamaludin, Ummu Kulthum and Md Ralib, Azrina and Mat Nor, Mohd Basri and Chase, Geoffrey and Pretty, Christopher G. (2019) Model-based glyceic control in a Malaysian intensive care unit: performance and safety study. Medical Devices: Evidence and Research, 2019 (12). pp. 215-226. ISSN 1179-1470 https://www.dovepress.com/model-based-glycemic-control-in-a-malaysian-intensive-care-unit-perfor-peer-reviewed-article-MDER
spellingShingle R Medicine (General)
Abu-Samah, Asma
Knopp, Jennifer Launa
Mohamad Suhaimi, Fatanah
Abdul Razak, Athirah
Abdul Razak, Normy Norfiza
Jamaludin, Ummu Kulthum
Md Ralib, Azrina
Mat Nor, Mohd Basri
Chase, Geoffrey
Pretty, Christopher G.
Model-based glyceic control in a Malaysian intensive care unit: performance and safety study
title Model-based glyceic control in a Malaysian intensive care unit: performance and safety study
title_full Model-based glyceic control in a Malaysian intensive care unit: performance and safety study
title_fullStr Model-based glyceic control in a Malaysian intensive care unit: performance and safety study
title_full_unstemmed Model-based glyceic control in a Malaysian intensive care unit: performance and safety study
title_short Model-based glyceic control in a Malaysian intensive care unit: performance and safety study
title_sort model-based glyceic control in a malaysian intensive care unit: performance and safety study
topic R Medicine (General)
url http://irep.iium.edu.my/72464/
http://irep.iium.edu.my/72464/
http://irep.iium.edu.my/72464/1/72464_Model-based%20glyceic%20control%20in%20a%20Malaysian.pdf