Remote Continuous Glucose Monitoring With a Computerized Insulin Infusion Protocol for Critically Ill Patients in a COVID-19 Medical ICU: Proof of Concept
| Autor: | Guillermo E. Umpierrez, Georgia Davis, Barbara McLean, Shivani Agarwal, Kathleen Dungan, Citlalli Perez-Guzman, Francisco J. Pasquel, Marina Rabinovich, Limin Peng, Eileen R Faulds, Norma Poindexter, Tara Walker, Joi C. Hester, Debbie Vigliotti, Patricia Hannon, Seema S. Tekwani, Petrena Saunders, Greg S. Martin |
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| Rok vydání: | 2021 |
| Předmět: |
Blood Glucose
Male medicine.medical_specialty Coronavirus disease 2019 (COVID-19) Critical Illness Point-of-Care Systems Endocrinology Diabetes and Metabolism medicine.medical_treatment 030209 endocrinology & metabolism Proof of Concept Study law.invention Diabetes Complications 03 medical and health sciences Insulin Infusion Systems 0302 clinical medicine law Diabetes mellitus Internal Medicine medicine Humans Insulin 030212 general & internal medicine Aged Aged 80 and over Advanced and Specialized Nursing Mechanical ventilation Protocol (science) SARS-CoV-2 Continuous glucose monitoring business.industry Critically ill Blood Glucose Self-Monitoring COVID-19 Middle Aged medicine.disease Intensive care unit COVID-19 Drug Treatment Novel Communications in Diabetes Clinical trial Intensive Care Units Equipment and Supplies Remote Sensing Technology Emergency medicine Female business Algorithms |
| Zdroj: | Diabetes Care |
| ISSN: | 1935-5548 0149-5992 |
| DOI: | 10.2337/dc20-2085 |
| Popis: | OBJECTIVE The use of remote real-time continuous glucose monitoring (CGM) in the hospital has rapidly emerged to preserve personal protective equipment and reduce potential exposures during coronavirus disease 2019 (COVID-19). RESEARCH DESIGN AND METHODS We linked a hybrid CGM and point-of-care (POC) glucose testing protocol to a computerized decision support system for continuous insulin infusion and integrated a validation system for sensor glucose values into the electronic health record. We report our proof-of-concept experience in a COVID-19 intensive care unit. RESULTS All nine patients required mechanical ventilation and corticosteroids. During the protocol, 75.7% of sensor values were within 20% of the reference POC glucose with an associated average reduction in POC of 63%. Mean time in range (70–180 mg/dL) was 71.4 ± 13.9%. Sensor accuracy was impacted by mechanical interferences in four patients. CONCLUSIONS A hybrid protocol integrating real-time CGM and POC is helpful for managing critically ill patients with COVID-19 requiring insulin infusion. |
| Databáze: | OpenAIRE |
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