Alternative site of real-time continuous glucose monitoring sensor application for abdominal surgery in the infraclavicular region

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F23%3A00084674" target="_blank" >RIV/00023001:_____/23:00084674 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11110/23:10467147 RIV/00216208:11120/23:43925985

Result on the web

<a href="https://journals.sagepub.com/doi/10.1177/19322968231194643" target="_blank" >https://journals.sagepub.com/doi/10.1177/19322968231194643</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1177/19322968231194643" target="_blank" >10.1177/19322968231194643</a>

Result language

angličtina

Original language name

Alternative site of real-time continuous glucose monitoring sensor application for abdominal surgery in the infraclavicular region

Original language description

Introduction: Real-time continuous glucose monitoring (rtCGM) is recently being considered for use in the inpatient care, supported by the promising results of its feasibility, safety and accuracy. Implementing rtCGM in the critical care setting is however more challenging both regarding the practical aspects and risk of impaired accuracy. We performed a pilot study to test the feasibility and suitable application site of rtCGM in postsurgical intensive care unit (ICU).Methods: The aim of this study was to test feasibility, safety and accuracy of rtCGM in the critical care and explore an alternative site of sensor placement in the infraclavicular region. We hypothesised that this novel insertion site could be more practical for the purpose of ICU care and patient manipulation and also eliminate the risk of sensor compression and inaccuracy in sedated patients. This was a pilot proof-of-concept study performed to find a suitable CGM placement for a larger prospective CGM accuracy trial. We included patients requiring ICU stay after major abdominal surgery. Dexcom G6 sensor, paired with an iPhone or Dexcom receiver was placed postoperatively in the tested infraclavicular site or standard upper arm site. Calibration was performed every 6 hours on Day 1, and once daily the following 2 days, using glucose values from blood gas analyser (Radiometer ABL 800) as reference. We assessed the sensor accuracy by calculating the mean absolute relative difference (MARD), bias, and computing the Surveillance Error Grid (SEG) analysis which evaluates the clinical impact of the sensor performance.Results: We included 14 patients after major abdomninal surgical procedures (liver transplantation n=6, pancreas resection n=7 and abdominal aortic repair n=1). Seven patients had the sensor placed in the in the infraclavicular region and seven in the standard upper arm site. In the infraclavicular site group, we obtained MARD of 5.5%, with 1.4% bias and 99.2% of paired values within the zone A and 0.8% in zone B of SEG, copmared to a MARD of 13.9%, bias of -9.9% bias, with 78.9% and 16.6% paired values in zones A and B of SEG, respectively, when using the standard upper arm placement. Median length of monitoring was 10 days in the infraclavicular site group (with average sensor usage in 100% of time) and 7 days (with average sensor usage 90.4% time) in the standard placement group.Conclusion: We present a novel CGM sensor placement site in the infraclavicular region, that had not been previously reported or tested, and was proved to be more accurate in the cohort of patients admitted to postoperative ICU. However, its implementation in clinical practice requires more evidence and validation.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

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

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2023

Confidentiality

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

Name of the periodical

Journal of diabetes science and technology

ISSN

1932-2968

e-ISSN

—

Volume of the periodical

17

Issue of the periodical within the volume

6

Country of publishing house

US - UNITED STATES

Number of pages

3

Pages from-to

1728-1730

UT code for WoS article

001178655900031

EID of the result in the Scopus database

2-s2.0-85170401999