Section: Contracts and Grants with Industry
TIght glycemic control for Intensive Care Units (LK2)
Participants : Alexandre Guerrini, Pierre Kalfon, Claire Médigue, Michel Sorine, Qinghua Zhang.
Collaboration with the Intensive Care Unit (ICU) of Chartres Hospital headed by Dr Pierre Kalfon.
This work on tight glycaemic control (TGC) for ICU started in Septembrer 2008. It is done in the framework of the CIFRE contract of Alexandre Guerrini with the small medtech company LK2 (Tours, France). For the medical context of this study, see  . Blood glucose has become a key biological parameter in critical care since publication of the study conducted by van den Berghe and colleagues  , who demonstrated decreased mortality in surgical intensive care patients in association with TGC, based on intensive insulin therapy. However, two negative studies were recently reported, which were interrupted early because of high rates of severe hypoglycaemia, namely the VISEP study  and the Glucontrol trial.
We have studied a possible origin of the failure of the recent study NICE-SUGAR  .
In this study, we aim at developing efficient monitoring and control tools that will help clinicians and nursing staff to control blood glucose levels in ICU patients, in particular to avoid hyperglycaemia superior to 10 mmol/l and hypoglycaemia episodes. A first controller has been designed and will be assessed. The controller determines the insulin infusion rate on the basis of the standard available glycaemia measurements despite their irregular sampling rate.