Clinical Risk Assesment of CS-1 Decision Support System
SINGLE-CENTER,OPEN,NON-CONTROLLED FEASIBILITY STUDY ON THE PERFORMANCE OF THE CS-1 DECISION SUPPORT SYSTEM WITH INCORPORATED SOFTWARE-ALGORITHM eMPC USED FOR BLOOD GLUCOSE CONTROL OVER 72 HOURS IN CRITICALLY ILL PATIENTS AT THE INTENSIVE CARE UNIT
研究概览
详细说明
Before the beginning of any trial related activities, the relatives of each patient will be asked if the patient has ever mentioned in the past, that he/she does not want do participate in any kind of clinical study. If this was said by the patient in the past or if there are any signs which make it likely that the patient would not participate, he/she will be excluded from the trial. After testing of the inclusion and exclusion criteria, screening information will be obtained a the beginning of the trial. A screening number will be assigned to the patient in ascending order. The following data will be recorded in the case record form (CRF): Check for inclusion/exclusion criteria,demographic data, medical (including diabetes) history and relevant medication, body weight and heightand laboratory analyses from routine laboratory assessment. Patients fulfilling all the inclusion criteria and none of the exclusion criteria will be included into the trial and a subject number will be assigned in ascending order. Routine intensive care will be provided from department of internal medicine. Trial related activities will not interfere with regular patient care. Blood samples will be retrieved from an arterial line, available for routine diagnostic and monitoring procedures in all patients. At time 0, a blood glucose measurement will be taken, manually entered into the CS-1 decision support system and both a insulin infusion rate and the time to next glucose reading will be suggested by the computer-based system. Based on the suggestion of the system, an insulin infusion pump as routinely used in the ICU will be manually set to this suggested insulin infusion rate by specially trained ICU staff but only if the staff feels safe with this suggestion. Intravenous infusion of human soluble insulin will then be started. For safety reasons: In case that the suggested measurement interval of the decision support system exceeds a 90 minute interval, interim glucose measurements will be taken. All measurements will be documented in the CRF. Only in case that the blood glucose values are below 40 mg/dl the additional interim-glucose value will also be put into the CS-1 system. However, the nursing staff can at any time decide to take an additionlal blood glucose measurement and/or neglect the decision as suggested by the system.
The target range for blood glucose levels will be 80-110 mg/dl [4.4 - 6.1 mmol/l]. The current blood glucose level and insulin infusion rate will continuously be documented by the CS-1 decision support system and supervised by the investigator. Glucose values will be provided to the system by manual entry. In case of hypoglycaemia, intravenous insulin infusion will be stopped and glucose will be administered via intravenous bolus.
The treatment visit, including all trial related activities as described above, will last for 72 hours. Adverse events and relevant medication will be continuously monitored and documented The Acute Physiology and Chronic Health Evaluation Score (Apache II) will be documented for each patient at the beginning of the trial. There is no physical connection between the algorithm suggesting the insulin infusion rate and the insulin infusion pump such as that the algorithm would be capable to independently steer the insulin infusion. There is also no physical connection between the glucose measurement device and the algorithm such as that the algorihthm would be able to independently get a glucose measurement. For safety reasons, both the glucose measurement and the insulin infusion rate are parameters that need to be manually entered by a specially trained nurse. For glucose measurement, a certified device for ICU application is being used (Accuchek® Inform; Roche Diagnostics), for intravenous insulin infusion, a certified insulin infusion pump (Perfusor® Space, BBraun Melsungen) as it is used under routine conditions in the ICU is being used. Follow up information will be acquired at hospital discharge or at the latest one week after visit 1. .
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
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Graz、奥地利、8036
- Medical University Graz
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- Age: > 18 years of age
- Stay in the ICU expected to be > 72 h
- Blood glucose > 110 mg/dl or patient on insulin treatment
Exclusion Criteria:
- Patients with hyperglycaemic crisis/ketoacidosis due to insulin deficiency.
- Known or suspected allergy to insulin
- Any disease or condition which the investigator or treating physician feels would interfere with the trial or the safety of the patient (i.e., liver failure, other fatal organ failures)
- Patients participating in another study
- Moribund patients likely to die within 24 hours
- Patients after organ transplantation within the last three months
- Patients under high dose cortisol treatment (cortisol > 1000 mg/day or equivalent dosis of hydrocortisol)
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:非随机化
- 介入模型:单组作业
- 屏蔽:无(打开标签)
研究衡量的是什么?
主要结果指标
结果测量 |
大体时间 |
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Percentage of time within predefined glucose target range 80-110mg/dL
大体时间:Start: Start of treatment ; End: Last glucose measurement under treatment
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Start: Start of treatment ; End: Last glucose measurement under treatment
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次要结果测量
结果测量 |
大体时间 |
---|---|
Hypoglycemias (<40mg/dl =2,2mM); Blood sampling frequency as adviced by device; Malfunctions of device Relevant-medication, nutrition; Insulin Infusion Rate; Blood glucose values; Handling/ usability of device;
大体时间:Start: Start of treatment, End: Last glucose measurement under treatment
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Start: Start of treatment, End: Last glucose measurement under treatment
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合作者和调查者
调查人员
- 首席研究员:Thomas R. Pieber, MD、Medical University of Graz
出版物和有用的链接
研究记录日期
研究主要日期
学习开始
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.
CS-1 DECISION SUPPORT SYSTEM的临床试验
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Crucell Holland BVThe PATH Malaria Vaccine Initiative (MVI); Seattle Children's Research Institute (SCRI)完全的
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Potomac Health FoundationsNational Institutes of Health (NIH); National Institute of Drug Abuse招聘中
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MicroPort Orthopedics Inc.The Ottawa Hospital; University of Ottawa完全的