CMTI Seminar Series: Geoff Chase, Ph.D.

Model-Based Therapeutics and Tight Glycemic Control: Model-Based Methods of Managing Complex Systems

Professor of Mechanical and Biomedical Engineering, University of Canterbury, New Zealand

Abstract

This seminar introduces the concept of model-based therapeutics, an approach using models and clinical data to develop novel, patient-specific methods of healthcare that improve outcomes at low or no cost. A specific case example is presented.

Hyperglycaemia is prevalent in critical care. Current published protocols use insulin alone to reduce blood glucose levels, require significant added clinical effort, and provide highly variable results. Most are ad-hoc and do not directly account for patient-specific metabolic status or variability. Equally, none directly address both the practical clinical difficulties, while also providing tight control.

A method of virtual trials is presented and its validation shown. The outcome tight glycemic control (TGC) protocols are then outlined in terms of their ability to deliver care and manage complexity and variability. The results and data presented make a clear case for TGC that matches existing physiological and clinical understanding, and shows how to begin achieving the positive outcomes, while simultaneously avoiding or mitigating often reported negative outcomes (e.g. hypoglycaemia).

Overall, this talk presents a novel inter-disciplinary approach to glycaemic control in the ICU and how a combined engineering-medicine approach can yield significant savings in mortality and cost. While TGC is the main focus of this discussion, the overall approach is quite general and can be expanded to other areas of care.