Blood Glucose Control Over an Extended Glucose Control Range in Postoperative Cardiac Surgery Patients in the Intensive Care Unit (Aldea_02)
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Purpose
Hyperglycaemia is commonly found in critically ill patients. Clinical studies demonstrated that tight blood glucose control in medical and surgical ICU patients results in a significant better outcome for the patients. Based on this emerging clinical evidence, there are increasing efforts worldwide to maintain strict glycaemic control in critically ill patients. However, achieving this goal requires extensive nursing efforts, including frequent bedside glucose monitoring and the implementation of complex intensive insulin infusion protocols. A fully automated algorithm may help to overcome some of these limitations by excluding intuitive interventions and integrating relevant clinical data in the decision-making process. This study will investigate the performance of an eMPC algorithm adjusted to target the range 4.4 - 8.3 mmol/L in line with the Surviving Sepsis guidelines.
| Condition | Intervention |
|---|---|
|
Critical Illness |
Other: enhanced model predictive control algorithm (eMPC) |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Single-center, Open Study on the Performance of the Software eMPC Algorithm Used for Blood Glucose Control Over an Extended Glucose Control Range (4.4 to 8.3 mmol/L) for a Maximum of 48 Hours in Postoperative Cardiac Surgery Patients in the Intensive Care Unit |
- percentage of time within the predefined glucose target range of 80-150 mg/dL [ Time Frame: from start of treatment to the last glucose measurement under treatment ] [ Designated as safety issue: Yes ]
- Hypoglycemias [ Time Frame: from start of treatment to the last glucose measurement under treatment ] [ Designated as safety issue: Yes ]
- Usability parameters like convenience of alarming function; workload; blood sampling frequency [ Time Frame: from start of treatment to the last glucose measurement under treatment ] [ Designated as safety issue: No ]
- Concomitant medication including insulin infusion rate, parenteral/enteral nutrition [ Time Frame: from start of treatment to the last glucose measurement under treatment ] [ Designated as safety issue: No ]
| Enrollment: | 20 |
| Study Start Date: | March 2009 |
| Study Completion Date: | July 2009 |
| Primary Completion Date: | July 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: eMPC
improved model predictive control algorithm (eMPC) for glycaemic control in ICU patients
|
Other: enhanced model predictive control algorithm (eMPC)
eMPC (software on a bedside computer) advised insulin titration to establish tight glycaemic control
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Age: > 18 years of age
- Admitted following cardiac surgery
- Stay in the ICU expected to be > 20h
- Blood glucose > 6.7 mmol/l within 4 hours of admission to intensive care or patient already receiving insulin treatment
Exclusion Criteria:
- Patients with hyperglycaemic crisis/ketoacidosis due to insulin deficiency.
- Known or suspected allergy to insulin
- Any disease or condition which the investigator or treating physician feels would interfere with the trial or the safety of the patient (i.e. liver failure, other fatal organ failures)
- Patients participating in another study
- Moribund patients likely to die within 24 hours
- Patients after organ transplantation within the last three months
- Patients under high dose cortisol treatment (cortisol > 1000 mg/day or equivalent doses of hydrocortisol)
Contacts and Locations| United Kingdom | |
| Royal Brompton Hospital and Harefield NHS Trust | |
| London, United Kingdom | |
| Principal Investigator: | Jeremy Cordingley, Dr. | Royal Brompton Hospital |
More Information
Publications:
| Responsible Party: | Dr. Norman Kachel, B. Braun Melsungen AG |
| ClinicalTrials.gov Identifier: | NCT00882427 History of Changes |
| Other Study ID Numbers: | HC-G-H-0807 |
| Study First Received: | April 15, 2009 |
| Last Updated: | February 4, 2010 |
| Health Authority: | United Kingdom: Research Ethics Committee |
Keywords provided by B. Braun Melsungen AG:
|
algorithm tight glycemic control glucose control |
intensive care insulin ICU |
Additional relevant MeSH terms:
|
Critical Illness Disease Attributes Pathologic Processes |
ClinicalTrials.gov processed this record on May 21, 2013