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Performance comparison between iit and star protocols in managing high blood glucose incidences in three main malaysian teaching icu medical centres / Che Zafirah Binti Rosly

By:

Che Zafirah Binti Rosly [author.]

Material type: Text

text

Media type:

unmediated

Carrier type:

volume

ISBN:

THE0010210 (Local)

Subject(s):

Dissertation note: Thesis (Master of Science) -- Universiti Malaysia Pahang – 2025 Abstract: Malaysia has a high mortality rate in the Intensive Care Unit (ICU). Various experiments were conducted to reduce the mortality rate among critical patients in Malaysia. It is known that ICU centre in Malaysia is using intensive insulin therapy (IIT) which has successfully managed the BG level within the targeted band to achieve required safety goals. However, alterations to the current practice needed to be considered to minimize the risk of severe low BG level and mortality cases while reducing the case of severe high BG level cases. Thus, this study aims to assess the performance of a new practice is known as the Stochastic Targeted (STAR) Protocol in managing BG levels in Malaysia ICU setting and to compare its performance between the three teaching hospitals. STAR is a tablet-computer based protocol that provides a patient-specific glucose control framework accounting for patient variability with a stochastically derived maximum 5% risk of severe low blood glucose level events. The patient’s BG levels, exogenous insulin and nutrition inputs were extracted from the ICU charts to create virtual patients by using the physiologically mathematical model. Three trials were simulated with controlled goal feed (GF) and without GF. This study focused on Glucerna as the primary nutritional input. The outcomes will be compared in terms of % BG within the targeted band of 4.0 to 10.0 mmol/L. The results indicate that the STAR virtual trial with controlled GF reduced the risk of severe high BG level measurements for all cohorts with respective increases of 9.6% (HTAA), 22.6% (PPUM), and 15.1% (HUSM) of desired BG level within the safety range of 4.0-10.0mmol/L.

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Holdings ( 2 )
Title notes ( 4 )

Holdings
Item type	Current library	Call number	Status	Date due	Barcode
Thesis	UMPLIB PEKAN	FTKMA .Z34 2025 r Thesis (Browse shelf(Opens below))	Not for loan		T000003859
Thesis	UMPLIB PEKAN	CD13800 (Browse shelf(Opens below))	Final Processing		T000003860

Faculty of Mechanical and Automotive Engineering Technology

Thesis (Master of Science) -- Universiti Malaysia Pahang – 2025

Includes bibliographical references

Malaysia has a high mortality rate in the Intensive Care Unit (ICU). Various experiments were conducted to reduce the mortality rate among critical patients in Malaysia. It is known that ICU centre in Malaysia is using intensive insulin therapy (IIT) which has successfully managed the BG level within the targeted band to achieve required safety goals. However, alterations to the current practice needed to be considered to minimize the risk of severe low BG level and mortality cases while reducing the case of severe high BG level cases. Thus, this study aims to assess the performance of a new practice is known as the Stochastic Targeted (STAR) Protocol in managing BG levels in Malaysia ICU setting and to compare its performance between the three teaching hospitals. STAR is a tablet-computer based protocol that provides a patient-specific glucose control framework accounting for patient variability with a stochastically derived maximum 5% risk of severe low blood glucose level events. The patient’s BG levels, exogenous insulin and nutrition inputs were extracted from the ICU charts to create virtual patients by using the physiologically mathematical model. Three trials were simulated with controlled goal feed (GF) and without GF. This study focused on Glucerna as the primary nutritional input. The outcomes will be compared in terms of % BG within the targeted band of 4.0 to 10.0 mmol/L. The results indicate that the STAR virtual trial with controlled GF reduced the risk of severe high BG level measurements for all cohorts with respective increases of 9.6% (HTAA), 22.6% (PPUM), and 15.1% (HUSM) of desired BG level within the safety range of 4.0-10.0mmol/L.