Increased blood glucose levels is not only a problem for diabetics; hyperglycaemia and insulin resistance are common in critically ill patients. ‘Recent medical studies have shown that strict glycaemic control and the implementation of an intensive glucose management protocol have contributed to reduce mortality and morbidity and shortened the length of patient stays in the ICU,’ said Dr Martin Ellmerer, Scientific Co-ordinator of the CLINICIP project at Graz Medical University. However, the control process has had to be carried out manually: a very time-consuming method, which also puts great responsibility on nurses, who must make intuitive decisions about the insulin dosage and thus face the risk of hypoglycaemia. ‘An adaptive control algorithm integrated into a system solution as it is being developed by the CLINICIP project team will reduce the workload and increase the safety and efficiency of insulin therapy. There is a great need for this solution in hospitals worldwide,’ Dr Ellmerer pointed out.
International and interdisciplinary teamwork
13 partners from seven European countries are working together on this project. Mainly they are from scientific or medical backgrounds, but also include s industrial partners such as B.Braun, which will use the project findings in its product design.
B.Braun predicts that the decision support system will be able to record therapy data, display trends and suggest insulin doses. It will also offer intelligent alarm monitoring. The idea is to optimise insulin therapy through an integrated control algorithm that automatically calculates the optimum insulin rate and suggests the time for the next glucose measurement. The system issues an automatic warning as soon as that measurement procedure must be carried out manually. Infusion data from enteral and parenteral nutrition pumps, which are influencing the insulin rate calculated by the control algorithm, will also be taken into account automatically.
‘We are currently in the feasibility study phase with a prototype, and we are optimistic that we will be able to provide the system in the foreseeable future, as we can count on the technology of our intelligent B. Braun Space infusion system. This platform is the essential basis for a challenging therapy like tight glycaemic control in the daily clinical routine,’ explained Dr Doris Röthlein, Senior Scientific Manager at B. Braun, adding: ‘The CLINICIP project is a perfect example of how clinicians, scientists and the industry can work together productively for the benefit of patients.’
The CLINICIP project is co-funded by the EU through the IST program under FP6, project reference IST FP6-506965.
Partners include B. Braun Melsungen AG; the Institute of Spectroscopy in Dortmund; Cambridge University, UK; Leuven’s Katholike Universiteit; Prague’s Charles University; the Graz Medical University; London’s Royal Brompton Hospital; SensLab GesmbH, Gambro Dialysatoren GmbH, Roche Diagnostics; Joanneum Research GmbH, and the Institute of Applied Physics in Florence.