Accuracy and reliability of real-time continuous glucose monitoring in the intensive care unit after major abdominal surgery including solid organ transplantation

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F23%3A00084384" target="_blank" >RIV/00023001:_____/23:00084384 - isvavai.cz</a>

Result on the web

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DOI - Digital Object Identifier

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Result language

angličtina

Original language name

Accuracy and reliability of real-time continuous glucose monitoring in the intensive care unit after major abdominal surgery including solid organ transplantation

Original language description

Background and aims: Blood glucose control in patients requiring intensive care remains a therapeutic challenge; however, recentadvancements in glucose sensing technologies have sparked interestin the potential use of real-time continuous glucose monitoring in thesubcutaneous compartment (rtCGM) also in the intensive care unit(ICU) setting. We performed a prospective clinical trial assessing theaccuracy and reliability of rtCGM in postoperative ICU patients aftermajor abdominal surgery.Materials and methods: Patients undergoing pancreas surgery, livertransplantation, simultaneous pancreas (or pancreatic islets) and kidney transplantation were enrolled in the trial. Dexcom G6 (Dexcom,Inc., San Diego, USA) was used for rtCGM. Arterial blood glucosemeasured by the amperometric principle (ABL 800, Radiometer,Copenhagen, Denmark) served as reference and to calibrate the Dexcom G6 (every 6 hours on day 1, once daily day 2 and 3). Sensoraccuracy was assessed by computing mean absolute relative diference (MARD), bias, modifed Bland-Altman plot and surveillanceerror grid for paired samples of glucose values from CGM and ABL.Results: Sixty-fve patients after major abdominal surgery staying inICU post-operatively were included into this analysis. We observedtechnical difculties leading to sensor loss in four patients. Medianmonitoring length was 7 days with a 95.1± 6.5% proportion of activeCGM use. Overall, 1548 paired glucose values measured with CGMand ABL were obtained. MARD for CGM compared with ABLmeasured glucose was 9.5% with a bias of 1.4% and coefcient ofvariation of 13.7%. In the surveillance error grid analysis, 98.7%of glucose value pairs were in the A and B zone of risk (92.6% and6.1% respectively).Conclusion: Our results show a clinically applicable accuracy andreliability of the Dexcom G6 continuous glucose monitoring systemin postoperative ICU. This opens up new possibilities in intensifying ICU glucose control, lowering hypoglycaemia risk and reducingnursing staf workload.

Czech name

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Czech description

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Type

O - Miscellaneous

CEP classification

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OECD FORD branch

30202 - Endocrinology and metabolism (including diabetes, hormones)

Project

<a href="/en/project/LX22NPO5104" target="_blank" >LX22NPO5104: National Institute for Research of Metabolic and Cardiovascular Diseases</a><br>

Continuities

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Publication year

2023

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů