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Contemp Clin Trials. 2016 Sep;50:1-4. doi: 10.1016/j.cct.2016.07.007. Epub 2016 Jul 6.

Results of a near continuous glucose monitoring technology in surgical intensive care and trauma.

Author information

1
Acute and Critical Care Surgery, Washington University in St. Louis, St. Louis, MO, United States. Electronic address: nohrae@wudosis.wustl.edu.
2
Acute and Critical Care Surgery, Washington University in St. Louis, St. Louis, MO, United States.

Abstract

INTRODUCTION:

Near-continuous glucose monitoring is expected to increase time in range (TIR) of 80-120mg/dL and to avoid hypoglycemia without increasing workload. We investigated a near-continuous glucose monitor in surgical critically ill and trauma patients.

METHODS:

Patients were enrolled at a surgical intensive care unit associated with a level 1 trauma center. Glucose measurements were compared to the gold standard Yellow Springs Instrument (YSI). The technology withdraws 0.13mL of blood every 15min from a central venous line, centrifuges the sample, and uses mid-infrared spectroscopy to measure glucose. We plotted a Clarke Error Grid, calculated Mean Absolute Relative Deviation (MARD) to analyze trend accuracy, and we present a Bland Altman plot of device versus standard glucose measurements.

RESULTS:

24 patients were enrolled. One patient was withdrawn due to poor blood return from central venous line. A total of 347 glucose measurements from 23 patients were compared to the gold standard. 94.8% of the data points were in zone A of the Clarke Error Grid and 5.2% in zone B. The MARD was 8.02%. The majority of data points achieved the benchmark for accuracy. The remaining 5.2% are clinically benign. The MARD was below 10%. The Bland Altman plot shows good agreement between the device and reference glucose measurements. There were no device related adverse events.

CONCLUSION:

Our data suggests that near continuous monitoring via infrared spectroscopy is safe and accurate for use in critically ill surgical and trauma patients. A large scale multi-center study is underway to confirm these findings.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT02211300.

KEYWORDS:

Accuracy; Blood glucose meter; Continuous glucose monitoring; Glucose control; Near-infrared spectroscopy; Surgical intensive care

PMID:
27394384
DOI:
10.1016/j.cct.2016.07.007
[Indexed for MEDLINE]

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