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Improving glycemic control in critically ill patients: personalized care to mimic the endocrine pancreas.

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cam.issuedOnline2018-08-02
dc.contributor.authorChase, J Geoffrey
dc.contributor.authorDesaive, Thomas
dc.contributor.authorBohe, Julien
dc.contributor.authorCnop, Miriam
dc.contributor.authorDe Block, Christophe
dc.contributor.authorGunst, Jan
dc.contributor.authorHovorka, Roman
dc.contributor.authorKalfon, Pierre
dc.contributor.authorKrinsley, James
dc.contributor.authorRenard, Eric
dc.contributor.authorPreiser, Jean-Charles
dc.contributor.orcidHovorka, Roman [0000-0003-2901-461X]
dc.date.accessioned2018-09-10T22:17:43Z
dc.date.available2018-09-10T22:17:43Z
dc.date.issued2018-08-02
dc.description.abstractThere is considerable physiological and clinical evidence of harm and increased risk of death associated with dysglycemia in critical care. However, glycemic control (GC) currently leads to increased hypoglycemia, independently associated with a greater risk of death. Indeed, recent evidence suggests GC is difficult to safely and effectively achieve for all patients. In this review, leading experts in the field discuss this evidence and relevant data in diabetology, including the artificial pancreas, and suggest how safe, effective GC can be achieved in critically ill patients in ways seeking to mimic normal islet cell function. The review is structured around the specific clinical hurdles of: understanding the patient's metabolic state; designing GC to fit clinical practice, safety, efficacy, and workload; and the need for standardized metrics. These aspects are addressed by reviewing relevant recent advances in science and technology. Finally, we provide a set of concise recommendations to advance the safety, quality, consistency, and clinical uptake of GC in critical care. This review thus presents a roadmap toward better, more personalized metabolic care and improved patient outcomes.
dc.format.mediumElectronic
dc.identifier.doi10.17863/CAM.27449
dc.identifier.eissn1466-609X
dc.identifier.issn1364-8535
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/280085
dc.languageeng
dc.language.isoeng
dc.publisherSpringer Science and Business Media LLC
dc.publisher.urlhttp://dx.doi.org/10.1186/s13054-018-2110-1
dc.rightsAttribution 4.0 International (CC BY 4.0)
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectArtificial pancreas
dc.subjectEndocrine function
dc.subjectGlycemic control
dc.subjectIn silico
dc.subjectModel based
dc.subjectModeling
dc.subjectReview
dc.subjectValidation
dc.subjectVirtual patient
dc.subjectCritical Illness
dc.subjectGlycemic Load
dc.subjectHumans
dc.subjectHyperglycemia
dc.subjectHypoglycemia
dc.subjectIslets of Langerhans
dc.subjectMetabolism
dc.titleImproving glycemic control in critically ill patients: personalized care to mimic the endocrine pancreas.
dc.typeArticle
dcterms.dateAccepted2018-06-29
prism.issueIdentifier1
prism.publicationDate2018
prism.publicationNameCrit Care
prism.startingPage182
prism.volume22
rioxxterms.licenseref.startdate2018-08-02
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.typeJournal Article/Review
rioxxterms.versionVoR
rioxxterms.versionofrecord10.1186/s13054-018-2110-1

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