Study on the enhancement of Malaysian ICU centre and introduction of STAR performance
Stress-induced hyperglycaemia commonly occurred in the ICU. It is known that the majority of the ICU centre in Malaysia is using intensive insulin therapy (IIT) protocol in order to control glucose level in critically ill patient blood within the targeted level to achieve required safety goals. H...
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| Main Authors: | , , , , , , |
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| Format: | Book Chapter |
| Language: | English |
| Published: |
Springer Science and Business Media Deutschland GmbH
2022
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/97355/1/97355_Study%20on%20the%20enhancement%20of%20Malaysian%20ICU.pdf http://irep.iium.edu.my/97355/ https://link.springer.com/chapter/10.1007/978-981-16-4115-2_5 https://doi.org/10.1007/978-981-16-4115-2_5 |
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| Institution: | Universiti Islam Antarabangsa Malaysia |
| Language: | English |
| Summary: | Stress-induced hyperglycaemia commonly occurred in the ICU. It is
known that the majority of the ICU centre in Malaysia is using intensive insulin
therapy (IIT) protocol in order to control glucose level in critically ill patient blood
within the targeted level to achieve required safety goals. However, alterations to the
current practice needed to be considered to minimize the risk of hypoglycaemia and
mortality while reducing the case of hyperglycaemia event. Therefore, the objective of this research paper is to weigh and evaluate the performance of a modern
practice known as Stochastic Targeted (STAR) Protocol in managing blood glucose
(BG) levels in Malaysia ICU cohort and to compare its performance between the
three participating hospitals (HTAA, HUSM and PPUM) via MATLAB simulations.
STAR is a tablet-computer based protocols that provide patient-specific glucose
control framework accounting for patient variability with a stochastically derived
maximum 5% risk of hypoglycaemia events. The in-silico trials were simulated with
controlled goal feed (GF) and without GF. Only one type of nutrition is considered in
this study, which is Glucerna. The results show that all three ICU centre with STAR
simulation have a tight glycemic control with HTAA (83.6%), HUSM (76.8%) and
PPUM (80.6%) in terms of BG within the targeted band of 4.0–10.0 mmol/L. Also, the
median BG measurement level and insulin secretion shows decrease in percentage for
all ICU cohort, HTAA (12.3%; 30.2%), HUSM (21.6%; 9.9%) and PPUM (17.9%;
13.3%). The insulin sensitivity (SI) of STAR simulations have a significant increase |
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