Feasibility of Blood Glucose Control With the Space TGC System in Medical ICU Patients

NCT01164423 | Completed

• 1 other identifier: HC-G-H-0905
• Study Type: interventional
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

Hyperglycemia is common in critically ill patients and associated with an adverse outcome. Thus, glycaemic control is an important issue in critical care. Despite extensive efforts of the intensive care unit staff difficulties were experienced in achieving efficient and safe glucose control. 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. Space GlucoseControl (TGC system) is a decision support system which helps to achieve safe and reliable blood glucose control in the desired ranges. Information on parenteral and enteral nutrition is automatically integrated into the calculations. The primary objective of the current study is to investigate the performance and usability of the Space TGC system for glucose control in medical ICU patients.

Conditions

Critical Illness

Keywords

algorithm; tight glycemic control; glucose control; intensive care; insulin; ICU

Outcome Measures

Primary Outcomes (1)

• (arterial) blood glucose values -> percentage of time within predefined glucose target range 80-150 mg/dL

  all blood glucose measurements from start of treatment until last glucose measurement under treatment (i.e. stop of intravenous insulin treatment) up to a maximum of 14d

Secondary Outcomes (3)

• Hypoglycaemia ≤ 40 mg/dl (2.2mM)

  all blood glucose measurements from start of treatment until last glucose measurement under treatment (i.e. stop of intravenous insulin treatment) up to a maximum of 14d

• Concomitant medication including insulin infusion rate, parenteral/enteral nutrition

  all blood glucose measurements from start of treatment until last glucose measurement under treatment (i.e. stop of intravenous insulin treatment) up to a maximum of 14d

• Usability parameters like convenience of alarming function; workload; blood sampling frequency

  all blood glucose measurements from start of treatment until last glucose measurement under treatment (i.e. stop of intravenous insulin treatment) up to a maximum of 14d

Study Arms (1)

1

EXPERIMENTAL

Space TGC system with incorporated eMPC advised insulin infusion to establish glycaemic control

Device: Space TGC

Interventions

Space TGC DEVICE

Space TGC with incorporated eMPC algorithm to establish glycaemic control with a blood glucose target range of 80-150 mg/dL (4.4-8.3 mM)

1

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• age: \> 18 years of age
• stay in the ICU expected to be \> 72 h
• blood glucose \> 110 mg/dl or patient on insulin treatment

You may not qualify if:

• 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)
• moribund patients likely to die within 24 hours

Sponsors & Collaborators

• B. Braun Melsungen AG: lead

Study Sites (1)

Medizinische Universität Graz, Department of Internal Medicine

Graz, 8036, Austria

Location

Related Publications (3)

• Amrein K, Ellmerer M, Hovorka R, Kachel N, Parcz D, Korsatko S, Smolle K, Perl S, Bock G, Doll W, Kohler G, Pieber TR, Plank J. Hospital glucose control: safe and reliable glycemic control using enhanced model predictive control algorithm in medical intensive care unit patients. Diabetes Technol Ther. 2010 May;12(5):405-12. doi: 10.1089/dia.2009.0147.

  PMID: 20388051 BACKGROUND

• Kulnik R, Plank J, Pachler C, Wilinska ME, Groselj-Strele A, Rothlein D, Wufka M, Kachel N, Smolle KH, Perl S, Pieber TR, Hovorka R, Ellmerer M. Evaluation of implementation of a fully automated algorithm (enhanced model predictive control) in an interacting infusion pump system for establishment of tight glycemic control in medical intensive care unit patients. J Diabetes Sci Technol. 2008 Nov;2(6):963-70. doi: 10.1177/193229680800200606.

  PMID: 19885285 BACKGROUND

• Pachler C, Plank J, Weinhandl H, Chassin LJ, Wilinska ME, Kulnik R, Kaufmann P, Smolle KH, Pilger E, Pieber TR, Ellmerer M, Hovorka R. Tight glycaemic control by an automated algorithm with time-variant sampling in medical ICU patients. Intensive Care Med. 2008 Jul;34(7):1224-30. doi: 10.1007/s00134-008-1033-8. Epub 2008 Feb 23.

  PMID: 18297268 BACKGROUND

MeSH Terms

Conditions

Critical Illness; Insulin Resistance

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Hyperinsulinism; Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases

Study Officials

• Thomas R. Pieber, Prof.

  Landeskrankenhaus Universitätsklinikum Graz

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: INDUSTRY

Study Record Dates

• First Submitted: July 15, 2010
• First Posted: July 16, 2010
• Study Start: July 1, 2010
• Primary Completion: December 1, 2010
• Study Completion: December 1, 2010
• Last Updated: February 9, 2011

Record last verified: 2011-02

Locations

AU (1)