Institute of Medical and Biological Engineering, Seoul National University, Seoul 110-799, Korea.
IEEE Trans Biomed Eng. 2012 Jan;59(1):54-7. doi: 10.1109/TBME.2011.2163310. Epub 2011 Jul 29.
This letter presents an in silico evaluation method of glucose control protocols for critically ill patients with hyperglycemia. Although various glucose control protocols were introduced and investigated in clinical trials, development and validation of a novel glucose control protocol for critically ill patients require too much time and resources in clinical evaluation. We employed a virtual patient model of the critically ill patient with hyperglycemia and evaluated the clinically investigated glucose control protocols in a computational environment. The three-day simulation results presented the time profiles of glucose and insulin concentrations, the amount of enteral feed and intravenous bolus of glucose, and the intravenous insulin infusion rate. The hyperglycemia and hypoglycemia index, blood glucose concentrations, insulin doses, intravenous glucose infusion rates, and glucose feed rates were compared between different protocols. It is shown that a similar hypoglycemia incidence exists in simulation and clinical results. We concluded that this in silico simulation method using a virtual patient model could be useful for predicting hypoglycemic incidence of novel glucose control protocols for critically ill patients, prior to clinical trials.
这封信提出了一种针对高血糖危重症患者血糖控制方案的计算机模拟评估方法。尽管在临床试验中已经引入和研究了各种血糖控制方案，但对于危重症患者的新型血糖控制方案的开发和验证，在临床评估中需要耗费大量的时间和资源。我们采用了高血糖危重症虚拟患者模型，并在计算环境中评估了临床研究中的血糖控制方案。为期三天的模拟结果呈现了葡萄糖和胰岛素浓度、肠内喂养量和静脉推注葡萄糖量以及静脉内胰岛素输注率的时间曲线。不同方案之间的高血糖和低血糖指数、血糖浓度、胰岛素剂量、静脉葡萄糖输注率和葡萄糖喂养率进行了比较。结果表明，模拟和临床结果中的低血糖发生率相似。我们得出结论，使用虚拟患者模型的这种计算机模拟方法可用于预测新型血糖控制方案在临床试验之前对危重症患者的低血糖发生率。
