Smartest Doc
Pilot study of a model-based approach to blood glucose control in very-low-birthweight neonates Full Text
BMC Pediatrics, 08/20/2012
Le Compte AJ et al. – A computer model that accurately captures the dynamics of neonatal metabolism can provide safe and effective blood glucose control without increasing hypoglycemia.
Methods- Initial short-term 24-hour trials were performed on 8 VLBW infants with hyperglycemia followed by long-term trials of several days performed on 22 infants.
- Median birthweight was 745g and 760g for short-term and long-term trial infants, and median gestational age at birth was 25.6 and 25.4 weeks respectively.
- Blood glucose control is compared to 21 retrospective patients from the same unit who received insulin infusions determined by sliding scales and clinician intuition.
- Reduction in hyperglycemia towards the target glucose band was achieved safely in all cases during the short-term trials with no hypoglycemic episodes.
- Lower median blood glucose concentration was achieved during clinical implementation at 6.6 mmol/L (IQR: 5.5 - 8.2mmol/L, 1,003 measurements), compared to 8.0 mmol/L achieved in similar infants previously (p < 0.01).
- No significant difference in incidence of hypoglycemia during long-term trials was observed (p = 0.51).
- Percentage of blood glucose within the target range was increased by 83% compared to the retrospective cohort (p < 0.01).
