Model Predictive Control of the Blood Glucose Concentration for Critically Ill Patients in Intensive Care Units

In this paper we present a linear model predictive control (MPC) algorithm for control of the blood glucose concentration of critically ill patients in an intensive care unit (ICU). We present a version of the algorithm that is suitable for automatic control. The algorithm can administer insulin and glucose.

The insulin and glucose are administered using a parenteral (intravenous) route. We use a hysteresis logic to switch between insulin and glucose administration to prevent simultaneous administration of insulin and glucose. We test our algorithm in silico using three different simulation models to demonstrate the closed-loop performance of the algorithm.

The MPC algorithm is based on linear models in the form of parsimonious second-order transfer functions describing the effect of intravenously injected insulin and glucose on the blood glucose concentration and a first-order disturbance transfer function containing an integrator to ensure offset-free control.

The numerical results show that even in the ideal case without any measurement delay, tight glycemic control (80-110 mg/dL) cannot be achieved. Moreover, parenteral glucose is a requirement to avoid hypoglycemia and ensure extended tight glycemic control (60-140 mg/dL).