scholarly journals Accuracy and Reliability of Continuous Glucose Monitoring in the Intensive Care Unit: A Head-to-Head Comparison of Two Subcutaneous Glucose Sensors in Cardiac Surgery Patients

Diabetes Care ◽  
2011 ◽  
Vol 34 (3) ◽  
pp. e31-e31 ◽  
Author(s):  
S. E. Siegelaar ◽  
T. Barwari ◽  
J. Hermanides ◽  
W. Stooker ◽  
P. H. J. van der Voort ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Glucose Sensors

The Accuracy of Continuous Glucose Monitoring in the Medical Intensive Care Unit

2021 ◽  
pp. 193229682110275
Author(s):  
Wannita Tingsarat ◽  
Patinut Buranasupkajorn ◽  
Weerapan Khovidhunkit ◽  
Patchaya Boonchaya-anant ◽  
Nitchakarn Laichuthai
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Continuous Glucose Monitoring ◽  
Medical Intensive Care Unit ◽  
Glucose Monitoring ◽  
Relative Difference ◽  
Risk Zone ◽  
Medical Intensive Care ◽  
Vasopressor Use ◽  
Error Grid

Objective: To assess the accuracy of continuous glucose monitoring (CGM) in medical intensive care unit (MICU) patients. Methods: A Medtronic Enlite® sensor accuracy was assessed versus capillary blood glucose (CBG) and plasma glucose (PG) using the mean absolute relative difference (MARD), surveillance error grid (SEG) analysis and modified Bland-Altman plots. Results: Using CBG as a reference, MARD was 6.6%. Overall, 99.7% of the CGM readings were within the “no risk” zone. No significant differences in accuracy were seen within vasopressor subgroups. Using PG as the reference, MARD was 8.8%. The surveillance error grid analysis showed 95.2% of glucose readings were within the “no risk” zone. There were no device-related adverse events. Conclusion: The CGM sensor showed acceptable accuracy in MICU patients, regardless of vasopressor use.

scholarly journals Implementation of a Continuous Glucose Monitoring Program at a Safety Net Hospital During Covid 19 Pandemic

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A345-A346
Author(s):  
Erin E Finn ◽  
Lindsay Schlichting ◽  
Rocio Ines Pereira
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Continuous Glucose Monitoring ◽  
Monitoring Program ◽  
Glucose Monitoring ◽  
Safety Net ◽  
Surgical Intensive Care Unit ◽  
Close Monitoring ◽  
Safety Net Hospital ◽  
Urban Safety

Abstract Background: COVID 19 disproportionately impacts individuals with diabetes leading to increased morbidity and mortality. Hyperglycemia is common in hospitalized patients with COVID requiring intensive monitoring and management. Close monitoring of glucoses requires increased use of personal protective equipment (PPE), which has been in limited supply since the beginning of the pandemic. The FDA granted conditional allowance for use of continuous glucose monitors (CGM) in hospital settings during the COVID pandemic to allow for preservation of PPE. We present the process of implementing a continuous glucose monitoring program in an urban safety net hospital. Methods: The program was implemented at a county urban safety net hospital. Patients were eligible to be started on Dexcom G6 CGM if they had hyperglycemia requiring multiple insulin injections daily, were in contact isolation, and were located in 1 of 3 units of the hospital (medical intensive care unit [MICU], surgical intensive care unit, COVID 19 floor unit). Initial program was started in the MICU and subsequently expanded. Nurses and staff underwent training using videos, in-person demonstrations, and written guides. Informational Technology modified the electronic medical system to allow for ordering and documentation of CGM values by nurses. Supplies were stored both on unit and in central supply allowing for primary team to initiate monitoring independent of diabetes team. Records of patients participating in program were maintained by the diabetes team. Amount of PPE saved was estimated to be 10 instances/day while on insulin drip and 3/day when using subcutaneous insulin. Results: A total of 69 patients used a CGM during their hospital course. Average age was 56 years old, 69 % were male, average BMI 31, and 84% had known diabetes prior to admission. The majority of patients were critically ill with 68% intubated, 48% on vasopressors, 6% requiring dialysis, 38% on insulin drip, 46% were on tube feeds, and 74% received steroids. The racial demographics of the patients were 72% White, 3% Black, 4% Native American, 4% Asian, and 14% other. For ethnicity, 73% identified as Hispanic and half spoke Spanish as their primary language. An estimated 2600 instances of PPE were saved. Challenges that were faced in implementing the program included consistent training of large numbers of staff, maintaining supplies in stock, troubleshooting discordant values, and restricting use of CGM to patients who met qualifications. Conclusion: Overall, the implementation of CGM was successful and received a positive response. Staff in the primary units quickly became comfortable with the application of the technology. Potential challenges in the future include ongoing training, improving troubleshooting of technology, validating the accuracy of the devices, and developing funding for CGM equipment and interpretation.

Continuous glucose monitoring in the neonatal intensive care unit: need for practical guidelines – Authors' reply

2021 ◽  
Vol 5 (5) ◽  
pp. e16
Author(s):  
Kathryn Beardsall ◽  
Lynn Thomson ◽  
Isabel Iglesias-Platas ◽  
Mirjam M van Weissenbruch ◽  
Simon Bond ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Continuous Glucose Monitoring ◽  
Neonatal Intensive Care ◽  
Glucose Monitoring ◽  
Practical Guidelines

scholarly journals A Minimally Invasive Device for Continuous Glucose Monitoring in Infants

2008 ◽  
Vol 2 (2) ◽  
Author(s):  
Christopher P. Erdman ◽  
Stephen M. Goldman ◽  
Patrick J. Lynn ◽  
Matthew C. Ward
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Minimally Invasive ◽  
Neonatal Intensive Care Unit ◽  
Continuous Glucose Monitoring ◽  
Neonatal Intensive Care ◽  
Glucose Monitoring ◽  
Polarized Light ◽  
Invasive Device ◽  
Minimally Invasive Device

Blood sugar management is particularly critical in the neonatal intensive care unit where the incidence of hypoglycemia is high and patients run the risk of brain damage. The staff at most hospitals obtain glucose levels in infants by drawing blood from the heel, which is a cause for recurrent pain. Some infants undergo this procedure every 1–3hours for up to a few months. Our goal is to design a minimally invasive device that allows for real-time glucose monitoring in very low birth weight infants in the neonatal intensive care unit (NICU). This glucose monitor will reduce the amount of pain and physiological stress on the infants, decrease the risk of hypoglycemia in neonates and reduce the workload on hospital staff. There is currently much room for emerging technologies in this market as it trends towards less pain and faster responses. The device should only slightly hinder the infant’s motion, be as painless as possible, and all materials used in contact with the body need to be biologically inert and cause no irritation or allergic reaction. The device will utilize a microneedle array to extract interstitial fluid and draw it through a hydrophilic polyurethane membrane and into a polarimetry chamber. Circularly polarized light will be passed through the chamber and the differential absorbance of left and right polarized light will be used to calculate the glucose concentration. A literature and patent review showed that each separate portion could be used in an effective device for minimally invasive, continuous glucose monitoring.

scholarly journals Glucose Control in the Intensive Care Unit by Use of Continuous Glucose Monitoring: What Level of Measurement Error Is Acceptable?

2014 ◽  
Vol 60 (12) ◽  
pp. 1500-1509 ◽  
Author(s):  
Malgorzata E Wilinska ◽  
Roman Hovorka
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Measurement Error ◽  
Continuous Glucose Monitoring ◽  
Glucose Control ◽  
Glucose Monitoring ◽  
Glucose Variability ◽  
Glucose Measurement ◽  
Target Range ◽  
Mean Glucose

Abstract BACKGROUND Accuracy and frequency of glucose measurement is essential to achieve safe and efficacious glucose control in the intensive care unit. Emerging continuous glucose monitors provide frequent measurements, trending information, and alarms. The objective of this study was to establish the level of accuracy of continuous glucose monitoring (CGM) associated with safe and efficacious glucose control in the intensive care unit. METHODS We evaluated 3 established glucose control protocols [Yale, University of Washington, and Normoglycemia in Intensive Care Evaluation and Surviving Using Glucose Algorithm Regulation (NICE-SUGAR)] by use of computer simulations. Insulin delivery was informed by intermittent blood glucose (BG) measurements or CGM levels with an increasing level of measurement error. Measures of glucose control included mean glucose, glucose variability, proportion of time glucose was in target range, and hypoglycemia episodes. RESULTS Apart from the Washington protocol, CGM with mean absolute relative deviation (MARD) ≤15% resulted in similar mean glucose as with the use of intermittent BG measurements. Glucose variability was also similar between CGM and BG-informed protocols. Frequency and duration of hypoglycemia were not worse by use of CGM with MARD ≤10%. Measures of glucose control varied more between protocols than at different levels of the CGM error. CONCLUSIONS The efficacy of CGM-informed and BG-informed commonly used glucose protocols is similar, but the risk of hypoglycemia may be reduced by use of CGM with MARD ≤10%. Protocol choice has greater influence on glucose control measures than the glucose measurement method.

Comparison of subcutaneous and intravenous continuous glucose monitoring accuracy in an operating room and an intensive care unit

2015 ◽  
Vol 19 (2) ◽  
pp. 159-166 ◽  
Author(s):  
Masaya Munekage ◽  
Tomoaki Yatabe ◽  
Masahiko Sakaguchi ◽  
Hiroyuki Kitagawa ◽  
Takahiko Tamura ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Operating Room ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Monitoring Accuracy

876-P: Accuracy of Continuous Glucose Monitoring Compared with Capillary Blood and Venous Plasma Glucose Measurements in Medical Intensive Care Unit Patients

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 876-P
Author(s):  
WANNITA TINGSARAT ◽  
NITCHAKARN LAICHUTHAI ◽  
PATCHAYA BOONCHAYA-ANANT ◽  
PATINUT BURANASUPKAJORN ◽  
WEERAPAN KHOVIDHUNKIT
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Continuous Glucose Monitoring ◽  
Plasma Glucose ◽  
Medical Intensive Care Unit ◽  
Glucose Monitoring ◽  
Capillary Blood ◽  
Medical Intensive Care ◽  
Venous Plasma
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