Head-to-head comparison of two continuous glucose monitoring systems on a cardio-surgical ICU

Punke, Mark A.; Decker, Carole; Petzoldt, Martin; Reuter, Daniel A.; Wodack, Karin; Reichenspurner, H.; Kubik, Mathias; Kluge, Stefan

doi:10.1007/s10877-018-0221-5

Cited by 9 publications

(4 citation statements)

References 20 publications

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“…The correlation coefficient for Sentrino ® was 0.76 and 0.92 for the Glucoclear ® . 11 Interestingly, the only device having a better correlation coefficient in this context (Glucoclear ® ) is based on direct blood analysis, with blood having to be drown out of the patient for each analysis.…”

Section: Discussionmentioning

confidence: 99%

Continuous Glucose Monitoring System After Coronary Artery Bypass Graft Surgery: A Feasibility Study

Torre,

Schlotterbeck,

Ferraro

et al. 2024

Asian Cardiovasc Thorac Ann

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Background Blood glucose level variability has been associated with increased risk of complication in the postoperative setting of cardiovascular surgery. Although interesting for optimization of blood glucose management in this context, continuous blood glucose (CBG) devices can have a limited reliability in this context, in particular because of the use of paracetamol. The aim of this study was to evaluate the reliability of Dexcom G6®, a recently developed continuous glucose monitoring device. Methods We performed a prospective, observational, non-randomized, single-centre study comparing Dexcom G6® CBG level monitoring with the standard methods routinely used in this context. The standard blood glucose values were paired to the time corresponding values measured with Dexcom G6®. Agreement between the two methods and potential correlation in case of paracetamol use were calculated. Results From May 2020 to August 2021, 36 out of 206 patients operated for isolated coronary artery bypass grafting were enrolled; 673 paired blood glucose level were analyzed. Global agreement (ρc) was 0.85 (95% C.I.: 0.84–0.86), intensive care unit agreement was 0.78 (95%C.I.: 0.74–0.82) and ward agreement was 0.91 (95%C.I.: 0.89–0.93). In the diabetic population, it was 0.87 (95%C.I.: 0.85–0.90). When paracetamol was used, the difference was 0.02 mmol/l (95%C.I.: 0.29–0.33). Conclusions Dexcom G6® provides good blood glucose level accuracy in the postoperative context of cardiac surgery compared to the standard methods of measurements. The results are particularly reliable in the ward where the need for repeated capillary glucose measurements implies patient discomfort and time-consuming manipulations for the nursing staff.

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Section: Discussionmentioning

confidence: 99%

Continuous Glucose Monitoring System After Coronary Artery Bypass Graft Surgery: A Feasibility Study

Torre,

Schlotterbeck,

Ferraro

et al. 2024

Asian Cardiovasc Thorac Ann

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“…This has been done in different setups, such as in the lactose tolerance test, [1] in patients administered basal-bolus insulin, [2] during pregnancy, [3] and during resuscitation. [4] Among other types of glucose measurement methods are comparisons of continuous real time monitoring with venous level, [5] earlobe site versus nger tips, [6] subcutaneous versus intravenous in an operating room, [7] several blood glucose meters, [8,9] two continuous glucose monitoring systems in a cardio-surgical ICU, [10] between point-of-care testing and venous method in gestational diabetes, [11] and continuous monitoring in surgical ICU with capillary method. [12] All these studies used the Bland-Altman (B-A) method13 for assessing agreement.…”

Section: Introductionmentioning

confidence: 99%

An alternative simple method of assessment of clinical agreement of two methods of measuring blood glucose level without Bland–Altman limits

Indrayan

2023

Preprint

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New methods of measuring blood glucose levels are generally accepted when they show sufficient agreement with the existing established method. Such agreement is almost always assessed by Bland-Altman (B-A) method. This method of assessing agreement has several limitations such as this does not assess the degree of agreement and it requires uniform clinical tolerance limits. We describe a simple and robust method of assessing the agreement between two methods of measuring blood glucose levels that directly uses the clinical tolerance limits and assesses the degree of agreement without calculating the B-A limits. This alternative is more flexible also as the clinical tolerance limits can be varyingly set to provide more accuracy at critical values of the blood glucose level and relaxed at not-so-critical

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“…Ideally, blood glucose measurements should be done continuously, though continuous glucose monitoring (CGM) for critically ill patients may not be accurate enough, with wide limits of agreement despite small mean bias[ 12 ]. CGM appears unreliable when using minimally-invasive subcutaneous devices that assay interstitial glucose measurements[ 13 - 15 ], and does not seem to improve glucose control[ 16 ]. Although invasive (intravascular) CGM devices may have an acceptable accuracy, some drawbacks include vascular and infectious complications (thrombosis, catheter occlusion, biofilm formation, or intravascular catheter-related infection)[ 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Glycemic targets in critically ill adults: A mini-review

See¹

2021

WJD

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Illness-induced hyperglycemia impairs neutrophil function, increases pro-inflammatory cytokines, inhibits fibrinolysis, and promotes cellular damage. In turn, these mechanisms lead to pneumonia and surgical site infections, prolonged mechanical ventilation, prolonged hospitalization, and increased mortality. For optimal glucose control, blood glucose measurements need to be done accurately, frequently, and promptly. When choosing glycemic targets, one should keep the glycemic variability < 4 mmol/L and avoid targeting a lower limit of blood glucose < 4.4 mmol/L. The upper limit of blood glucose should be set according to casemix and the quality of glucose control. A lower glycemic target range ( i.e. , blood glucose 4.5-7.8 mmol/L) would be favored for patients without diabetes mellitus, with traumatic brain injury, or who are at risk of surgical site infection. To avoid harm from hypoglycemia, strict adherence to glycemic control protocols and timely glucose measurements are required. In contrast, a higher glycemic target range ( i.e. , blood glucose 7.8-10 mmol/L) would be favored as a default choice for medical-surgical patients and patients with diabetes mellitus. These targets may be modified if technical advances for blood glucose measurement and control can be achieved.

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Head-to-head comparison of two continuous glucose monitoring systems on a cardio-surgical ICU

Cited by 9 publications

References 20 publications

Continuous Glucose Monitoring System After Coronary Artery Bypass Graft Surgery: A Feasibility Study

Continuous Glucose Monitoring System After Coronary Artery Bypass Graft Surgery: A Feasibility Study

An alternative simple method of assessment of clinical agreement of two methods of measuring blood glucose level without Bland–Altman limits

Glycemic targets in critically ill adults: A mini-review

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