Accuracy of Intra-arterial and Subcutaneous Continuous Glucose Monitoring in Postoperative Cardiac Surgery Patients in the ICU

Abstract

The IA-CGM system directly measured arterial blood glucose and did not interfere with clinical care. However, accuracy was similar to that of the less invasive SC-CGM device.

Use of an Intravascular Fluorescent Continuous Glucose Sensor in ICU Patients

“…Data have previously been reported from outpatient studies and 2 of the 4 inpatient sites. [7][8][9][10] Methods…”

The effect of perioperative glucose control on postoperative insulin resistance

“…Direct comparisons between intravenous and subcutaneous CGMS show diverging results. One study demonstrated superior accuracy for the intravascular devise 255 , and the other reported no difference in accuracy 256 , though increased frequency of calibration was suggested to produce higher accuracy in subcutaneous CGMS readings 257 . Recently, Bocchichio et al demonstrated high accuracy for an intravenous CGM system compared to reference values, in addition presented data in both the hyper-and hypoglycemic range 248 , the latter is often lacking in trials.…”

Metabolic Management during Critical Illness: Glycemic Control in the ICU

“…These indwelling units read ambient glucose in venous blood real time. [83][84][85][86] Other devices categorized as "intravascular" actually draw blood to and through an external sensor, subsequently either recirculated or discarded. The GlucoScout (International Biomedical Ltd., Austin, TX) is now FDA-approved for sampling arterial or venous blood every 5 minutes.…”

“…As for the intravascular devices, preliminary investigations have demonstrated them to be reasonably accurate in the ICU setting with low rates of device-related complications, although mainly in small, short-term studies. [83][84][85][86] Three randomized trials of CGM in the inpatient setting have been conducted to date. In two studies, by Boom et al 96 and Kopecký et al, 91 no differences in glycemic control could be demonstrated with the more expensive CGM versus more conventional intermittent assessments either using arterial or capillary BG.…”