Automatic infusion system based on an adaptive patient model
First Claim
1. An apparatus comprising:
- a sensor to produce a signal indicative of glycemia levels in a patient, said patient characterized by a patient profile,a programmable actuator adapted to deliver a blood glucose regulator to said patient at an administration rate anda control system adapted to regulate said administration rate of said blood glucose regulator,wherein a model-based predictive controller based on an adaptive dynamic patient model predicts a future response of said patient'"'"'s glycemia to said administration rate of said blood glucose regulator as a function of time and compensates effects of external disturbance on said patients'"'"' glycemia by adjusting said administration rate of said blood glucose regulator to achieve a status of normoglycemia in said patient, which is a critically ill patient andwherein said adaptive dynamic patient model comprising parameter settings corresponds to a model for which;
in an initial phase, the parameter settings are determined based on the patient profile comprising variables including on-admission parameters, which determine the class of the patient, whereby each class is associated with distinct parameters for the model; and
after the initial phase, the parameter settings are adapted by the incoming signal to more closely approximate the dynamic behaviour of the glycemia in the patient.
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Abstract
Present invention is a system of blood glucose monitoring and intensive insulin therapy in a ICU for strict maintenance of normoglycemia which reduces intensive care and hospital mortality and morbidity of critically ill adult patients. The findings of present study also reveal factors determining insulin doses needed to maintain normoglycemia as well as the impact of insulin dose versus blood glucose level on the observed outcome benefits have been established. The invention provides a control system that adapts the flow of the insulin infusion based on insulin requirement calculated by blood glucose levels and clinical parameters such as history of diabetes, Body Mass Index, blood glucose level on admission, reason of ICU admission, time in the ICU, type and severity of illness, caloric intake, obesity, drugs affecting insulin sensitivity). This automated insulin monitoring systems significantly reduces the workload and human resource management problems for intensive insulin therapy in patients in the ICU.
208 Citations
17 Claims
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1. An apparatus comprising:
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a sensor to produce a signal indicative of glycemia levels in a patient, said patient characterized by a patient profile, a programmable actuator adapted to deliver a blood glucose regulator to said patient at an administration rate and a control system adapted to regulate said administration rate of said blood glucose regulator, wherein a model-based predictive controller based on an adaptive dynamic patient model predicts a future response of said patient'"'"'s glycemia to said administration rate of said blood glucose regulator as a function of time and compensates effects of external disturbance on said patients'"'"' glycemia by adjusting said administration rate of said blood glucose regulator to achieve a status of normoglycemia in said patient, which is a critically ill patient and wherein said adaptive dynamic patient model comprising parameter settings corresponds to a model for which; in an initial phase, the parameter settings are determined based on the patient profile comprising variables including on-admission parameters, which determine the class of the patient, whereby each class is associated with distinct parameters for the model; and after the initial phase, the parameter settings are adapted by the incoming signal to more closely approximate the dynamic behaviour of the glycemia in the patient. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A method for the treatment of a critically ill patient under a condition of insulin resistance or under a condition of increased glucose turnover, which comprises administering to a critically ill patient, characterized by a patient profile, a blood glucose regulator using an apparatus comprising:
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a sensor to produce a signal indicative of the glycemia levels in said patient; a programmable actuator adapted to deliver said blood glucose regulator to said patient at an administration rate; and a control system adapted to regulate the administration level rate of said blood glucose regulator, wherein said apparatus comprises a model-based predictive controller based on an adaptive dynamic patient model which predicts a future response of said patient'"'"'s glycemia to said administration rate of said blood glucose regulator as a function of time and compensates effects of external disturbance on said patient'"'"'s glycemia by adjusting said administration rate of said blood glucose regulator to achieve a status of normoglycemia in said critically ill patient and wherein said adaptive dynamic patient model comprising parameter settings corresponds to a model for which; in an initial phase, the parameter settings are determined based on the patient profile comprising variables including on-admission parameters, which determine the class of the patient, whereby each class is associated with distinct parameters for the model; and after the initial phase, the parameter settings are adapted by the incoming signal to more closely approximate the dynamic behaviour of the glycemia in the patient. - View Dependent Claims (12, 13, 14, 15, 16)
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17. A method for the treatment of a critically ill patient, to prevent or decrease the incidence of blood stream infection, to reduce morbidity and mortality in the critical care, to prevent or decrease the incidence of prolonged inflammation, to prevent or decrease the incidence of acute renal failure, to prevent or decrease the incidence of polyneuropathy, to prevent or decrease the incidence of immune-mediated destruction of the beta cells, to prevent or decrease the incidence of systemic inflammatory response syndrome (SIRS) to prevent or decrease the incidence of sepsis, to prevent or decrease the incidence of endoneural edema, to prevent or decrease the incidence of phrenic nerves or to decrease dialysis or hemofiltration, which comprises administering a blood glucose regulator to a critically ill patient, characterized by a patient profile, using an apparatus comprising:
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a sensor to produce a signal indicative of the glycemia levels in said patient; a programmable actuator adapted to deliver a blood glucose regulator to said patient at an administration rate; and a control system adapted to regulate the administration rate of said blood glucose regulator; wherein said apparatus comprises a model-based predictive controller based on an adaptive dynamic patient model which predicts a future response of the patient'"'"'s glycemia to said administration rate of said blood glucose regulator as a function of time and compensates effects of external disturbance on said patient'"'"'s glycemia by adjusting said administration rate of the blood glucose regulator to achieve a status of normoglycemia in said critically ill patient and wherein said adaptive dynamic patient model comprising parameter settings corresponds to a model for which; in an initial phase, the parameter settings are determined based on the patient profile comprising parameters including on-admission parameters, which determine the class of the patient, whereby each class is associated with distinct parameters for the model; and after the initial phase, the parameter settings are adapted by the incoming signal to more closely approximate the dynamic behaviour of the glycemia in the patient.
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Specification