Real-Time Continuous Glucose Monitoring in an Intensive Care Unit: Better Accuracy in Patients with Septic Shock

Abstract

This study assessed the accuracy of real-time continuous glucose monitoring system (RTCGMS) devices in an intensive care unit (ICU) to determine whether the septic status of the patient has any influence on the accuracy of the RTCGMS. Subjects and methods: In total, 41 patients on insulin therapy were included. Patients were monitored for 72 h using RTCGMS. Arterial blood glucose (ABG) samples were obtained following the protocol established in the ICU. The results were evaluated using paired values (excluding those used for calibration) with the performance assessed using numerical accuracy. Nonparametric tests were used to determine statistically significant differences in accuracy. Results: In total, 956 ABG/RTCGMS pairs were analyzed. The overall median relative absolute difference (RAD) was 13.5%, and the International Organization for Standardization (ISO) criteria were 68.1%. The median RADs reported for patients with septic shock, with sepsis, and without sepsis were 11.2%, 14.3%, and 16.3%, respectively (P<0.05). Measurements meeting the ISO criteria were 74.5%, 65.6%, and 63.7% for patients with septic shock, with sepsis, and without sepsis, respectively (P<0.05). Conclusions: The results showed that the septic status of patients influenced the accuracy of the RTCGMS in the ICU. Accuracy was significantly better in patients with septic shock in comparison with the other patient cohorts

Aquest estudi avalua la precisió dels sistemes de monitorització contínua de glucosa a temps real (SMCG-TR) a una Unitat de Medicina Intensiva (UMI), per a determinar si l’estat sèptic dels pacients influencia en la seva precisió. 41 pacients van ser inclosos, monitoritzant-se durant 72h. La glucèmia arterial (GA) es va determinar simultàniament. Els resultats van ser avaluats utilitzant dades aparellades, obtenint-se 956 GA/SMCG-TR dades aparellades. Els resultats mostraren que l’estat sèptic dels pacients influencia sobre la precisió dels SMCG-TR. La precisió va ser significativament millor en aquells pacients crítics amb Xoc sèptic en comparació amb la resta de pacients