Improving glycemic control in critically ill patients: personalized care to mimic the endocrine pancreas

@article{Chase2018ImprovingGC,
  title={Improving glycemic control in critically ill patients: personalized care to mimic the endocrine pancreas},
  author={J. Geoffrey Chase and Thomas Desaive and Julien Boh{\'e} and Miriam Cnop and Christophe E M De Block and Jan Gunst and Roman Hovorka and Pierre Kalfon and James S. Krinsley and Eric Renard and Jean-Charles Preiser},
  journal={Critical Care},
  year={2018},
  volume={22}
}
There is considerable physiological and clinical evidence of harm and increased risk of death associated with dysglycemia in critical care. However, glycemic control (GC) currently leads to increased hypoglycemia, independently associated with a greater risk of death. Indeed, recent evidence suggests GC is difficult to safely and effectively achieve for all patients. In this review, leading experts in the field discuss this evidence and relevant data in diabetology, including the artificial… 

The Long and Winding Road to Personalized Glycemic Control in the Intensive Care Unit.

  • M. Tickoo
  • Medicine
    Seminars in respiratory and critical care medicine
  • 2019
The pathophysiology and downstream effects of altered glycemic response in critical illness, management of glycemic control in the ICU, and future strategies toward personalization of critical care glycemic management are discussed.

Glucose control in the ICU.

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Given equivalent intra-patient variability and significantly greater insulin resistance, females can receive the same benefit from safe, effective GC as males, but may require higher insulin doses to achieve the same glycaemia.

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This study analyses the effect of estimating EGP for ICU patients with very low SI (severe insulin resistance) and its impact on identified, model-based insulin sensitivity identification, modeling accuracy, and model- based glycemic clinical control and provides new insight into the frequency and level of significantly increased EGP in critical illness.

PROBABILISTIC GLYCEMIC CONTROL DECISION SUPPORT IN ICU: PROOF OF CONCEPT USING BAYESIAN NETWORK

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