EU - CLINICIP - Closed Loop INsulin Infusion for Critically Ill Patients

Healthy people can develop atypical physiological symptoms under critically ill conditions, e.g. in the intensive care unit (ICU). Due to shock and trauma as a consequence of the surgery, the glucose concentration is likely to rise significantly comparable to the symptoms known as insulin-dependent Diabetes Mellitus. Similar to diabetes mellitus, the high glucose level needs to be treated with external insulin. According to a study in Belgium the intensive insulin therapy treatment cuts the mortality rates by 42% compared to standard insulin therapy for ICU indication. The project provides an intelligent system for improved health status monitoring of critically ill patients. A local system will be developed comprising biosensors for the determination of glucose in whole blood. Based on the continuous measurement, an adaptive control algorithm generates advice and thus represents a decision supporting system in an early project stage. Within a closed loop system intensified insulin treatment will make use of calculation results leading to the external regulation of glucose. In addition to the approach of controlling the glucose concentration, a minimally invasive treatment will be investigated. A number of biosensors for the determination of most important parameters such as lactate, carbon dioxide, oxygen and pH will be used to characterize adipose tissue. In order to support the implementation of intensified treatment in an optimal way, a telemedical infrastructure will be developed. This includes a knowledge-sharing environment, allowing the involved clinical centres to store and share their newly generated knowledge. Additionally all data resulting from clinical trials will be saved on the server. In later stages of the project, access to the data and the derived clinical recommendations for treatment of critically ill patient will be granted to additional clinical partners who are willing to implement improved treatment.