The effects of ICU specific nutrition management, as a human factor by using Stochastic Targeted glycaemic control

Abstract

The accurate glycaemic control in Intensive Care Units (ICUs) is a critical issue for physicians as a result of stress-induced blood glucose variability and high risk of hypoglycaemia. The STAR (Stochastic TARgeted) glycaemic control protocol is a model-based protocol, providing reduced risk of hypoglycaemia and stabilized blood glucose level by modulating insulin and nutrition inputs. The STAR framework is flexible, it allows clinicians to specify the target blood glucose range and the targeted nutrition intake of the patients (i.e. goal feed) according to the hospital’s feeding regime and the actual need of the patient. Thus, the differences in the clinical application of STAR in different hospitals can effect the clinical outcomes and the average delivered amount of nutritions during the patient’s treatment. This paper aims to analyse these effects by comparing the treatment outcomes of patients treated in two different hospitals, one in Christchurch, New Zealand and one in Gyula, Hungary.