Document Detail


Experience with the continuous glucose monitoring system in a medical intensive care unit.
MedLine Citation:
PMID:  15198837     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Strict glycemic control improves clinical outcomes in critically ill patients. However, practical tools for frequent monitoring of blood glucose (BG) levels in the intensive care unit (ICU) are limited. The Continuous Glucose Monitoring System (CGMS, Medtronic MiniMed, Northridge, CA) is currently approved for detecting glycemic excursions in outpatients with diabetes mellitus. The use of this device has never been carefully examined in the inpatient setting. This preliminary study was designed to investigate the accuracy of the CGMS in critically ill patients admitted to a medical ICU (MICU). Subjects at risk for hyperglycemia were recruited from among all patients admitted to our MICU. CGMS sensors were implanted for up to 72 h. Study subjects wore between one and five consecutive sensors. Four or more standard capillary BG readings were recorded per 24 h. All paired meter-sensor (M-S) readings were used both for CGMS calibration and for data analysis. Twenty-two MICU patients wore 41 CGMS sensors, yielding 546 M-S BG pairs. Overall, the Pearson correlation coefficient ( r ) was 0.88, with a mean M-S difference of 3.3 +/- 26.7 mg/dL (0.6 +/- 17.4%) and a mean absolute M-S difference of 19.7 +/- 18.3 mg/dL (12.8 +/- 11.9%). Clarke Error Grid analysis categorized 98.7% of the M-S pairs within "clinically acceptable" zones A and B. The CGMS is promising for potential use in critically ill patients. If validated in larger studies, the device could serve as a useful research tool for investigating the role of hyperglycemia (and strict glycemic control) in ICU patients. If further developed as a "real-time" glucose sensor, CGMS technology could ultimately prove clinically useful in the ICU, by decreasing nursing workload and/or by providing alarm signals for impending glycemic excursions.
Authors:
Philip A Goldberg; Mark D Siegel; Raymond R Russell; Robert S Sherwin; Joshua I Halickman; Dawn A Cooper; James D Dziura; Silvio E Inzucchi
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Diabetes technology & therapeutics     Volume:  6     ISSN:  1520-9156     ISO Abbreviation:  Diabetes Technol. Ther.     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-06-16     Completed Date:  2005-06-30     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  100889084     Medline TA:  Diabetes Technol Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  339-47     Citation Subset:  IM    
Affiliation:
Section of Endocrinology, Department of Medicine, Yale New Haven Hospital, Yale University School of Medicine, New Haven, Connecticut 06520-8020, USA.
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MeSH Terms
Descriptor/Qualifier:
APACHE
Adult
Aged
Blood Glucose / analysis*
Critical Illness*
Female
Humans
Hyperglycemia / blood,  prevention & control
Informed Consent
Intensive Care Units
Male
Middle Aged
Monitoring, Ambulatory / methods*
Patient Selection
Regression Analysis
Reproducibility of Results
Sensitivity and Specificity
Grant Support
ID/Acronym/Agency:
M01 RR-00125/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Blood Glucose

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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