Section: Bilateral Contracts and Grants with Industry

LK2 contract: TIght glycemic control for Intensive Care Units

Participants : Alexandre Guerrini, Michel Sorine.

This work on tight glycaemic control (TGC) for ICU started in Septembrer 2008 in the framework of the CIFRE contract of Alexandre Guerrini with the small medtech company LK2 (Tours, France). It is in collaboration with the Intensive Care Unit (ICU) of Chartres Hospital headed by Dr Pierre Kalfon. For the medical context of this study, see [90] .

Blood glucose has become a key biological parameter in critical care since publication of the study conducted by van den Berghe and colleagues [104] , 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 [85] and the Glucontrol trial.

After having studied a possible origin of the failure of the recent study NICE-SUGAR, we have worked on more robust control algorithms based on a database of representative “virtual patients” [87] .

In this study, we have developed efficient monitoring and control tools, now marketed by LK2 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. Our first controller has been assessed in the study CGAO-REA (see 5.3 ) with more than 3500 included patients. The controller determines the insulin infusion rate on the basis of the standard available glycaemia measurements despite their irregular sampling rate.