文献类型： 会议论文

第一作者： Jihan Zukhi

作者： Jihan Zukhi ¹ ; Fatanah M. Suhaimi ¹ ; Mohd Zulfakar Mazlan ² ; Ummu K. Jamaludin ³ ; Normy Razak ⁴ ; Mastura Mohd Sopian ⁵ ;

作者机构： 1.Craniofacial and Biomaterial Sciences Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia

2.Department of Anaesthesiology and Intensive Care, School of Medical Sciences, Universiti Sains Malaysia

3.Human Engineering Focus Group, Universiti Malaysia Pahang

4.College of Engineering, Universiti Tenaga Nasional

5.Oncological and Radiological Sciences Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia

关键词： Glycemic control;Critical care;Model-based glycemic control;Intensive care unit;HUSM

会议名称： IFAC World Congress

主办单位：

页码： 15964-15969

摘要： Insulin infusion protocol is the standard protocol that has been practiced in Malaysia's intensive care unit (ICU) for controlling the hyperglycemia. Multiple sliding scale method of the insulin infusion protocol may drive conflict in selecting an appropriate scale to be applied to the patient. The objective of this paper is to analyse the blood glucose outcome of eight sliding scales insulin infusion protocol adopted in the Universiti Sains Malaysia Hospital (HUSM). A retrospective data of 78 ICU patients of HUSM were fitted using a validated glucose-insulin system to identify insulin sensitivity profiles of the patients. Then, these SI profiles were simulated on various scale protocols. The results obtained from this study showed that among eight scales, Scale 4 had the highest percentage of BG within the HUSM's target of 6.0 - 10.0 mmol/L. Scale 1 had the highest percentage of BG for the BG measurement more than 10.0 mmol/L while Scale 8 had the highest percentage of BG measurement of less than 6.0 mmol/L. However, none of the scale shown better performance than the current clinical practice. Furthermore, all of the eight scales had a more substantial number of BG measurement compared to the clinical. This study shows that Scale 2 and Scale 3 result in a similar outcome. Similarly, Scale 5 is almost the same as Scale 6. Thus, at least two sets of scale can be combined to reduce the number of scales. The reduction of scales consequently avoid confusion and helps the clinician in selecting the appropriate scale to be applied to the patients. From this study, it can be concluded that the HUSM protocol is a combination of scales. The scales may be shifted from one to another scale depending on patient condition and clinician judgement. A proper guideline for the scale shifting seems necessary to allow optimum glycemic management in the ICU.

分类号： TP273-53