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

Kód výsledku v 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>

Nalezeny alternativní kódy

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

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

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

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

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

Popis výsledku anglicky

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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30202 - Endocrinology and metabolism (including diabetes, hormones)

Projekt

<a href="/cs/project/LX22NPO5104" target="_blank" >LX22NPO5104: Národní institut pro výzkum metabolických a kardiovaskulárních onemocnění</a><br>

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2023

Kód důvěrnosti údajů

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

Název periodika

Journal of diabetes science and technology

ISSN

1932-2968

e-ISSN

—

Svazek periodika

17

Číslo periodika v rámci svazku

6

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

3

Strana od-do

1728-1730

Kód UT WoS článku

001178655900031

EID výsledku v databázi Scopus

2-s2.0-85170401999