Timothy Lonergan

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INTRODUCTION Stress-induced hyperglycaemia is prevalent in critical care. Control of blood glucose levels to within a 4.4 to 6.1 mmol/L range or below 7.75 mmol/L can reduce mortality and improve clinical outcomes. The Specialised Relative Insulin Nutrition Tables (SPRINT) protocol is a simple wheel-based system that modulates insulin and nutritional inputs(More)
BACKGROUND Hyperglycemia is prevalent in critical care, and tight control can significantly reduce mortality. However, current protocols have been considered taxing to administer and may require extra staff. In addition, increased insulin resistance and saturation effects limit the level of control possible using insulin alone. Thus, regulating both insulin(More)
BACKGROUND Stress-induced hyperglycemia is prevalent in critical care, even in patients with no history of diabetes. Increased counter-regulatory hormone response increases gluconeogenesis and effective insulin resistance, which can be exacerbated by drug therapy. Control of blood glucose levels to the 4.0-6.1 mmol/L range has been shown to reduce mortality(More)
Targeted, tight model-based glycemic control in critical care patients that can reduce mortality 18-45% is enabled by prediction of insulin sensitivity, S(I). However, this parameter can vary significantly over a given hour in the critically ill as their condition evolves. A stochastic model of S(I) variability is constructed using data from 165 critical(More)
OBJECTIVE To examine the practical difficulties in managing hyperglycaemia in critical illness and to present recently developed model-based glycaemic management protocols to provide tight control. BACKGROUND Hyperglycaemia is prevalent in critical care. Current published protocols require significant added clinical effort and have highly variable(More)
OBJECTIVE Present a new model-based tight glycaemic control approach using variable insulin and nutrition administration. BACKGROUND Hyperglycaemia is prevalent in critical care. Current published protocols use insulin alone to reduce blood glucose levels, require significant added clinical effort, and provide highly variable results. None directly(More)
Hyperglycaemia is prevalent in critical care and tight control can reduce mortality from 9-43% depending on the level of control and the cohort. This research presents a table-based method that varies both insulin dose and nutritional input to achieve tight control. The system mimics a previously validated model-based system, but can be used for long term,(More)
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