Technology Imroves Odds for Critically Ill

CLINICIPLarge numbers of unnecessary deaths and avoidable medical complications in intensive care units (ICU) are attributable to the difficulties of treating high glucose levels in critically ill patients' blood. That is about to change for the better thanks to a new automated insulin delivery system developed by European researchers.

A common side effect of stress and trauma in critically ill patients is a rapid increase in blood glucose levels. As with diabetes, the levels can be reduced and controlled by the infusion of insulin. But glucose levels peak and change much more quickly in the ICU environment and there is little room for trial and error. If the situation is not normalised, then complications and even deaths can and do occur.

Twice in the past, Europe-wide studies and trials were put in place to try and come up with a solution to the problem. But in both cases they were prematurely halted because researchers could not solve the problem of overcompensating and patients developing hypoglycaemia, or abnormally low blood sugar levels.

"What these studies did clearly indicate is that the establishment of normal glucose levels in critically ill patients is very difficult to achieve without some sort of automated system to help the nurses," says Dr Martin Ellmerer, scientific coordinator of the CLINICIP project which has developed just such a system.

Nurses' no-nonsense approach
CLINICIP started by surveying ICUs in a number of European hospitals and interviewing nursing staff. "We found out that ICU staff did not want to see additional catheters in patients, they did not want extra equipment taking up space, and costs had to be kept right down so as not to eat into funds for other vital equipment," says Ellmerer. "So, right from the start the requirements were really tough."

Partners in this EU-funded project, academic medical institutions plus one private-sector medical equipment manufacturer, decided they needed to develop a two-step approach. "We first developed a decision-support system which met all the criteria outlined by the ICU staff, and later developed a fully automated system," he tells ICT Results.

At the heart of both systems is a sophisticated bit of computer software (an algorithm) written especially for this project.

With the decision-support system, nurses still have to draw blood from patients in the traditional way and test it for glucose levels. They enter the information via the user interface - a touch screen - the researchers have developed. The algorithm takes over at this stage, calculates how much insulin is needed and automatically administers it. It also alerts the nurse when a new blood sample needs to be taken and analysed - half an hour in the worst cases and up to four hours in less severe cases.

"We have fully functioning prototypes of the decision-support system which we successfully trialled in ICUs at different hospitals around Europe," Ellmerer says. The project's industrial partner, B. Braun Melsungen AG, is ready to go into commercial production of the system working together with the clinical partners.

"We will first have to go through an approval process and the systems should be commercially available to hospitals in mid-2009," Ellmerer says. B. Braun is one of the leading manufacturers of infusion systems used in hospitals, and the CLINICIP technology will be incorporated into these as it was during the trials.

Developing the real deal
At the same time the prototype was being developed and tested, CLINICIP researchers were working on sensors for a fully automated, closed-loop control system to both monitor glucose levels and administer insulin with no involvement from a nurse.

The drawback of this is that a dedicated needle is necessary. "Unfortunately, this is unavoidable for a fully automated system," Ellmerer points out. Using fibre-optic technology the needle draws blood, sends it for analysis and then returns it to the patient's vein as well as administering the necessary dose of insulin.

"We have performed a proof-of-concept study to show we are able to establish glucose control in a clinical setting," Ellmerer says.

To develop the sensor technology further and then commercialise it, a spin-off company will be set up with Ellmerer as CEO and one of the shareholders. The other shareholders are individuals from project partners in CLINICIP. The spin-off will work closely with B. Braun and the partners, although they are not stakeholders in it.

Ellmerer expects the fully automated two-step system to be commercially available in 2011.

"Our research and the products which result from it should have a pretty fundamental impact on ICUs," he says. "They should improve survival chances, reduce complications, such as sepsis and organ failure, and reduce the time patients need to spend in ICUs."

For further information, please visit:
http://www.clinicip.org

Source: ICT Results

Related news articles:

Most Popular Now

Using Data and AI to Create Better Healt…

Academic medical centers could transform patient care by adopting principles from learning health systems principles, according to researchers from Weill Cornell Medicine and the University of California, San Diego. In...

AI Medical Receptionist Modernizing Doct…

A virtual medical receptionist named "Cassie," developed through research at Texas A&M University, is transforming the way patients interact with health care providers. Cassie is a digital-human assistant created by Humanate...

Northern Ireland Completes Nationwide Ro…

Go-lives at Western and Southern health and social care trusts mean every pathology service is using the same laboratory information management system; improving efficiency and quality. An ambitious technology project to...

AI Tool Set to Transform Characterisatio…

A multinational team of researchers, co-led by the Garvan Institute of Medical Research, has developed and tested a new AI tool to better characterise the diversity of individual cells within...

AI Detects Hidden Heart Disease Using Ex…

Mass General Brigham researchers have developed a new AI tool in collaboration with the United States Department of Veterans Affairs (VA) to probe through previously collected CT scans and identify...

Human-AI Collectives Make the Most Accur…

Diagnostic errors are among the most serious problems in everyday medical practice. AI systems - especially large language models (LLMs) like ChatGPT-4, Gemini, or Claude 3 - offer new ways...

MHP-Net: A Revolutionary AI Model for Ac…

Liver cancer is the sixth most common cancer globally and a leading cause of cancer-related deaths. Accurate segmentation of liver tumors is a crucial step for the management of the...

Highland Marketing Announced as Official…

Highland Marketing has been named, for the second year running, the official communications partner for HETT Show 2025, the UK's leading digital health conference and exhibition. Taking place 7-8 October...

Groundbreaking TACIT Algorithm Offers Ne…

Researchers at VCU Massey Comprehensive Cancer Center have developed a novel algorithm that could provide a revolutionary tool for determining the best options for patients - both in the treatment...