Fifteen-minute Frequency of Glucose Measurements and the Use of Threshold Alarms: Impact on Mitigating Dysglycemia in Critically Ill Patients
| Autor: | David I. Bruns, Jean-Charles Preiser, James C. Boyd, Irl B. Hirsch, Eden Nohra, Laura J. Moore, Grant V. Bochicchio, Stanley A. Nasraway, James S. Krinsley, Kelly Bochicchio, Anthony P. Furnary |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Blood Glucose
medicine.medical_specialty Glucose control endocrine system diseases Endocrinology Diabetes and Metabolism Critical Illness Biomedical Engineering Bioengineering Hypoglycemia 03 medical and health sciences 0302 clinical medicine Internal Medicine medicine Humans 030212 general & internal medicine Glycemic Retrospective Studies Continuous glucose monitoring business.industry Critically ill Glucose Measurement nutritional and metabolic diseases 030208 emergency & critical care medicine Original Articles medicine.disease Hyperglycemia Emergency medicine business |
| Zdroj: | J Diabetes Sci Technol |
| Popis: | Background: The use of near-continuous blood glucose (BG) monitoring has the potential to improve glycemic control in critically ill patients. The MANAGE IDE trial evaluated the performance of the OptiScanner (OS) 5000 in a multicenter cohort of 200 critically ill patients. Methods: An Independent Group reviewed the BG run charts of all 200 patients and voted whether unblinded use of the OS, with alarms set at 90 and 130 to 150 mg/dL to alert the clinical team to impending hypoglycemia and hyperglycemia, respectively, would have eliminated episodes of dysglycemia: hypoglycemia, defined as a single BG 4 hours of BG >150 mg/dL; severe hyperglycemia, defined as >4 hours of BG >200 mg/dL and increased glucose variability (GV), defined as coefficient of variation (CV) >20%. Results: At least one episode of dysglycemia occurred in 103 (51.5%) of the patients, including 6 (3.0%) with hypoglycemia, 83 (41.5%) with hyperglycemia, 18 (9.0%) with severe hyperglycemia, and 40 (20.0%) with increased GV. Unblinded use of the OS with appropriate alarms would likely have averted 97.1% of the episodes of dysglycemia: hypoglycemia (100.0%), hyperglycemia (96.4%), severe hyperglycemia (100.0%), and increased GV (97.5%). Point accuracy of the OS was very similar to that of the point of care BG monitoring devices used in the trial. Conclusion: Unblinded use of the OS would have eliminated nearly every episode of dysglycemia in this cohort of critically ill patients, thereby markedly improving the quality and safety of glucose control. |
| Databáze: | OpenAIRE |
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