Blood Glucose Control in Neonatal Intensive Care with Model-Based Controllers

Premature neonates often experience hyperglycaemia, which has been linked to increased mortality and worsened outcomes. Insulin therapy can assist in controlling blood glucose levels. However a reliable, robust control protocol is required to avoid hypoglycaemia and to meet nutrition goals. This study presents an adaptive, model-based predictive controller designed to incorporate the unique metabolic state and control parameters of the neonate. Controller performance was tested in virtual trials on a 25 patient retrospective cohort and 24-hour pilot clinical trials. The effects of measurement frequency and BG sensor error were also evaluated. Time in the 4 – 7 mmol/L BG band was increased by 110%–145% compared to retrospective control for that cohort, with fewer hypoglycaemic measurements. Controllers were robust to BG sensor errors.