The ICU environment is a very chaotic setting with critically ill patients demanding 100% focus from the bedside nurses who are responsible for their care. Given the constant and sometimes overwhelming demands placed on ICU nurses, they have little time to take on any extra burdens, yet glucose control using today’s technology has been shown to take up to 2 hours of nursing time per patient per day. Even then, safe and effective glucose control remains difficult to achieve, with ICU patients still suffering from high rates of hypoglycemia, hyperglycemia and large glucose variability, despite the best efforts of the ICU nursing staff. Poor performance with regards to these three glucose control metrics can increase overall ICU patient morbidity and mortality rates by up to 40%.
Currently, blood glucose control in an ICU consists of the nurse drawing blood from the patient, measuring the blood glucose level on a bedside glucose meter, then either looking up a new intravenous insulin dose on a paper chart or typing the glucose level into a computer and having the computer suggest a new insulin dose. With the newly recommended insulin dose in hand, the nurse then goes back to the patient’s bedside and manually adjusts the rate of intravenous (IV) insulin on the IV pump. In order to maintain good blood glucose control, the nurse may have to repeat this process on an hourly basis. This control process is considered to be open loop, as human intervention remains within the control process. This means that human error can be introduced at all three steps of the process: 1) glucose measurement, 2) insulin dose determination, 3) IV pump adjustment.
The FUSION Artificial Intelligence (AI) based Artificial Pancreas system developed by Ideal Medical Technologies is a closed loop system that acts autonomously and only requires 20 minutes of daily nursing time to manage, with most of this time spent on daily replacement of the IV insulin and glucose (dextrose) used by the FUSION system.
This will allow the nurse to spend up to 100 more minutes a day on direct patient care, which should serve to improve the overall quality of patient care. In addition, the FUSION Artificial Pancreas system will be able to safely and effectively keep the ICU patient’s blood glucose level in the range that the treating physician feels is most appropriate, while at the same time avoiding the glucose metrics than can increase ICU patients morbidity/mortality rates – hypoglycemia, hyperglycemia and increased glucose variability.
Effective glucose control will have the direct effect of improving patient outcomes and saving healthcare resources, and the indirect effect of allowing the nursing staff to spend more time on direct patient care which should serve to improve the overall quality of care and patient experience.