eHealth Intelligent glucose monitoring
Devices to regulate the blood-sugar levels of critically ill patients in intensive care wards are set to improve treatment and even save lives when they go into commercial use in the coming years.
Developed by the CLINICIP project, the intelligent devices address a potentially fatal side effect of trauma and shock: rapid increases in the body’s glucose levels that intensive care unit (ICU) doctors and nurses have typically found hard to control.
As with diabetes, high glucose levels in trauma patients can be brought down through infusions of insulin. However, in an ICU environment the changes are often more rapid, and an excessive dose of insulin can lead to dangerously low blood sugar, a condition known as hypoglycaemia.
Controlling the risks of irregular blood sugar
The CLINICIP team saw where technology could come to the aid of ICU patients. Working in collaboration with several European hospitals, they developed and tested a device to support nurses in deciding how much insulin and how frequently to administer it, while also working towards a more advanced system that would automate insulin injections entirely.
The decision-support device, which is expected to be commercially available in 2009 after further trials, still relies on nurses drawing blood from patients and testing glucose levels in the traditional way.
However, instead of administering the insulin directly they input the glucose information into the device via a touch screen. A specially designed algorithm then calculates how much insulin is needed before administering it to the patient. The device alerts nurses when blood samples need to be taken, which can be as frequently as every half hour.
Using the system in trials, just one hypoglycaemic event was recorded in 434 ICU days.
Automatic insulin injections
The automated version of the system, which the project partners expect to make available commercially in 2011, goes one step further in order to minimise the need for nurses to intervene.
Using a glucose-monitoring interface and an insulin-infusion interface in a closed-loop system, the device draws blood samples from the patient automatically, calculates the insulin required to bring their blood sugar within normal levels, then administers the correct dose.
Improving patients’ chances of survival
Clinical trials in Europe have shown that such a device would probably dramatically improve the survival chances of critically ill patients who develop irregular glucose levels. Although hospitals frequently check blood sugar in ICU patients, few have implemented tight controls because of the risks of overcompensating and the need to have more nursing staff dedicated to glucose control.
CLINICIP’s automated system overcomes both those problems, while its decision-support device reduces the risks of nurses giving an incorrect insulin dose.
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