Alternative Site of Real-Time Continuous Glucose Monitoring Sensor Application for Abdominal Surgery in the Infraclavicular Region

Voglová Hagerf, Barbora; Protuš, Marek; Németová, Lenka; Kieslichová, Eva; Uchytilová, Eva; Mráz, Miloš; Girman, Peter; Švirlochová, Veronika; Franeková, Janka; Jabor, Antonín

doi:10.1177/19322968231194643

J Diabetes Sci Technol

2023

DOI: 10.1177/19322968231194643

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Alternative Site of Real-Time Continuous Glucose Monitoring Sensor Application for Abdominal Surgery in the Infraclavicular Region

Barbora Voglová Hagerf,

Marek Protuš,

Lenka Németová

et al.

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2024

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Cited by 2 publications

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Continuous peri-operative glucose monitoring in noncardiac surgery

Putzu,

Grange,

Schorer

et al. 2024

European Journal of Anaesthesiology

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BACKGROUND Glucose management is an important component of peri-operative care. The usefulness of continuous glucose monitoring (CGM) in noncardiac surgery is uncertain. OBJECTIVE To systematically assess the glycaemic profile and clinical outcome of patients equipped with a CGM device during the peri-operative period in noncardiac surgery. DESIGN Systematic review. DATA SOURCES Electronic databases were systematically searched up to July 2024. ELIGIBILITY CRITERIA Any studies performed in the peri-operative setting using a CGM device were included. Closed-loop systems also administering insulin were excluded. Analyses were stratified according to diabetes mellitus status and covered intra-operative and postoperative data. Outcomes included glycaemic profile (normal range 3.9 to 10.0 mmol l−1), complications, adverse events, and device dysfunction. RESULTS Twenty-six studies (1016 patients) were included. Twenty-four studies were not randomised, and six used a control arm for comparison. In bariatric surgery, diabetes mellitus patients had a mean ± SD glucose of 5.6 ± 0.5 mmol l−1, with 15.4 ± 8.6% time below range, 75.3 ± 5.5% in range and 9.6 ± 6.7% above range. During major surgery, diabetes mellitus patients showed a mean glucose of 9.6 ± 1.1 mmol l−1, with 9.5 ± 9.1% of time below range, 56.3 ± 13.5% in range and 30.6 ± 13.9% above range. In comparison, nondiabetes mellitus patients had a mean glucose of 6.4 ± 0.6 mmol l−1, with 6.7 ± 8.4% time below range, 84.6 ± 15.5% in range and 11.2 ± 4.9% above range. Peri-operative complications were reported in only one comparative study and were similar in CGM and control groups. Device-related adverse events were rare and underreported. In 9.21% of cases, the devices experienced dysfunctions such as accidental removal and issues with sensors or readers. CONCLUSION Due to the limited number of controlled studies, the impact of CGM on postoperative glycaemic control and complications compared with point-of-care testing remains unknown. Variability in postoperative glycaemic profiles and a device dysfunction rate of 1 in 10 suggest CGM should be investigated in a targeted surgical group.

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Continuous peri-operative glucose monitoring in noncardiac surgery

Putzu,

Grange,

Schorer

et al. 2024

European Journal of Anaesthesiology

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Accuracy and Feasibility of Real-time Continuous Glucose Monitoring in Critically Ill Patients After Abdominal Surgery and Solid Organ Transplantation

Voglová Hagerf,

Protus,

Nemetova

et al. 2024

Diabetes Care

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OBJECTIVE Glycemia management in critical care is posing a challenge in frequent measuring and adequate insulin dose adjustment. In recent years, continuous glucose measurement has gained accuracy and reliability in outpatient and inpatient settings. The aim of this study was to assess the feasibility and accuracy of real-time continuous glucose monitoring (CGM) in ICU patients after major abdominal surgery. RESEARCH DESIGN AND METHODS We included patients undergoing pancreatic surgery and solid organ transplantation (liver, pancreas, islets of Langerhans, kidney) requiring an ICU stay after surgery. We used a Dexcom G6 sensor, placed in the infraclavicular region, for real-time CGM. Arterial blood glucose measured by the amperometric principle (ABL 800; Radiometer, Copenhagen, Denmark) served as a reference value and for calibration. Blood glucose was also routinely monitored by a StatStrip bedside glucose meter. Sensor accuracy was assessed by mean absolute relative difference (MARD), bias, modified Bland-Altman plot, and surveillance error grid for paired samples of glucose values from CGM and acid-base analyzer (ABL). RESULTS We analyzed data from 61 patients and obtained 1,546 paired glucose values from CGM and ABL. Active sensor use was 95.1%. MARD was 9.4%, relative bias was 1.4%, and 92.8% of values fell in zone A, 6.1% fell in zone B, and 1.2% fell in zone C of the surveillance error grid. Median time in range was 78%, with minimum (<1%) time spent in hypoglycemia. StatStrip glucose meter MARD compared with ABL was 5.8%. CONCLUSIONS Our study shows clinically applicable accuracy and reliability of Dexcom G6 CGM in postoperative ICU patients and a feasible alternative sensor placement site.

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Alternative Site of Real-Time Continuous Glucose Monitoring Sensor Application for Abdominal Surgery in the Infraclavicular Region

Cited by 2 publications

References 10 publications

Continuous peri-operative glucose monitoring in noncardiac surgery

Continuous peri-operative glucose monitoring in noncardiac surgery

Accuracy and Feasibility of Real-time Continuous Glucose Monitoring in Critically Ill Patients After Abdominal Surgery and Solid Organ Transplantation

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