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Study on the Enhancement of Malaysian ICU Centre and Introduction of STAR Performance

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dc.contributor.authorRosly C.Z.en_US
dc.contributor.authorJamaludin U.K.en_US
dc.contributor.authorKhalid K.en_US
dc.contributor.authorSuhaimi F.en_US
dc.contributor.authorAbdul Razak N.N.en_US
dc.contributor.authorMat Nor M.B.en_US
dc.contributor.authorMd Ralib A.en_US
dc.contributor.authorid57193915509en_US
dc.contributor.authorid55330889600en_US
dc.contributor.authorid57193918513en_US
dc.contributor.authorid36247893200en_US
dc.contributor.authorid37059587300en_US
dc.contributor.authorid57226799207en_US
dc.contributor.authorid57278164400en_US
dc.date.accessioned2023-05-29T09:42:23Z
dc.date.available2023-05-29T09:42:23Z
dc.date.issued2022
dc.descriptionBlood; Glucose; Insulin; Intensive care units; Patient treatment; Stars; Stochastic systems; Hyperglycaemia; Hypoglycaemia; Intensive insulin therapies; Performance; Stochastic targeted; Stochastics; Stress induced hyperglycemia; Stress-induced; MATLABen_US
dc.description.abstractStress-induced hyperglycaemia commonly occurred in the ICU. It is known that the majority of the ICU centre in Malaysia is using intensive insulin therapy (IIT) protocol in order to control glucose level in critically ill patient blood within the targeted level to achieve required safety goals. However, alterations to the current practice needed to be considered to minimize the risk of hypoglycaemia and mortality while reducing the case of hyperglycaemia event. Therefore, the objective of this research paper is to weigh and evaluate the performance of a modern practice known as Stochastic Targeted (STAR) Protocol in managing blood glucose (BG) levels in Malaysia ICU cohort and to compare its performance between the three participating hospitals (HTAA, HUSM and PPUM) via MATLAB simulations. STAR is a tablet-computer based protocols that provide patient-specific glucose control framework accounting for patient variability with a stochastically derived maximum 5% risk of hypoglycaemia events. The in-silico trials were simulated with controlled goal feed (GF) and without GF. Only one type of nutrition is considered in this study, which is Glucerna. The results show that all three ICU centre with STAR simulation have a tight glycemic control with HTAA (83.6%), HUSM (76.8%) and PPUM (80.6%) in terms of BG within the targeted band of 4.0�10.0�mmol/L. Also, the median BG measurement level and insulin secretion shows decrease in percentage for all ICU cohort, HTAA (12.3%; 30.2%), HUSM (21.6%; 9.9%) and PPUM (17.9%; 13.3%). The insulin sensitivity (SI) of STAR simulations have a significant increase when compared with IIT protocol, HTAA (26.1%), HUSM (33.3%) and PPUM (50%). The Kruskal-Wallis test was utilized to test the BG, SI and insulin secretion median. There are significant differences between IIT protocol and STAR simulations among the three cohorts ICU centre with p-value < 0.05. � 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.en_US
dc.description.natureFinalen_US
dc.identifier.doi10.1007/978-981-16-4115-2_5
dc.identifier.epage73
dc.identifier.scopus2-s2.0-85116869809
dc.identifier.spage63
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85116869809&doi=10.1007%2f978-981-16-4115-2_5&partnerID=40&md5=02c73ff438c988a15f27d1147cf1789f
dc.identifier.urihttps://irepository.uniten.edu.my/handle/123456789/27302
dc.publisherSpringer Science and Business Media Deutschland GmbHen_US
dc.sourceScopus
dc.sourcetitleLecture Notes in Mechanical Engineering
dc.titleStudy on the Enhancement of Malaysian ICU Centre and Introduction of STAR Performanceen_US
dc.typeConference Paperen_US
dspace.entity.typePublication
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