Document Detail

Microcirculation and its relation to continuous subcutaneous glucose sensor accuracy in cardiac surgery patients in the intensive care unit.
MedLine Citation:
PMID:  23879929     Owner:  NLM     Status:  Publisher    
OBJECTIVE: Continuous glucose monitoring could be helpful for glucose regulation in critically ill patients; however, its accuracy is uncertain and might be influenced by microcirculation. We investigated the microcirculation and its relation to the accuracy of 2 continuous glucose monitoring devices in patients after cardiac surgery.
METHODS: The present prospective, observational study included 60 patients admitted for cardiac surgery. Two continuous glucose monitoring devices (Guardian Real-Time and FreeStyle Navigator) were placed before surgery. The relative absolute deviation between continuous glucose monitoring and the arterial reference glucose was calculated to assess the accuracy. Microcirculation was measured using the microvascular flow index, perfused vessel density, and proportion of perfused vessels using sublingual sidestream dark-field imaging, and tissue oxygenation using near-infrared spectroscopy. The associations were assessed using a linear mixed-effects model for repeated measures.
RESULTS: The median relative absolute deviation of the Navigator was 11% (interquartile range, 8%-16%) and of the Guardian was 14% (interquartile range, 11%-18%; P = .05). Tissue oxygenation significantly increased during the intensive care unit admission (maximum 91.2% [3.9] after 6 hours) and decreased thereafter, stabilizing after 20 hours. A decrease in perfused vessel density accompanied the increase in tissue oxygenation. Microcirculatory variables were not associated with sensor accuracy. A lower peripheral temperature (Navigator, b = -0.008, P = .003; Guardian, b = -0.006, P = .048), and for the Navigator, also a higher Acute Physiology and Chronic Health Evaluation IV predicted mortality (b = 0.017, P < .001) and age (b = 0.002, P = .037) were associated with decreased sensor accuracy.
CONCLUSIONS: The results of the present study have shown acceptable accuracy for both sensors in patients after cardiac surgery. The microcirculation was impaired to a limited extent compared with that in patients with sepsis and healthy controls. This impairment was not related to sensor accuracy but the peripheral temperature for both sensors and patient age and Acute Physiology and Chronic Health Evaluation IV predicted mortality for the Navigator were.
Sarah E Siegelaar; Temo Barwari; Jeroen Hermanides; Peter H J van der Voort; Joost B L Hoekstra; J Hans Devries
Related Documents :
24615479 - Value of 18fluorodeoxyglucose-positron-emission tomography in amyotrophic lateral scler...
23297379 - Differences between episodic and chronic tension-type headaches in nociceptive-specific...
23171639 - New high-cutoff dialyzer allows improved middle molecule clearance without an increase ...
23178689 - Remodeling of the cardiac sodium channel, connexin43, and plakoglobin at the intercalat...
23639239 - Vesicouretral reflux with neuropathic bladder: studying the resolution rate after ileoc...
23129009 - Increased carboxyhemoglobin level during liver resection with inflow occlusion.
15377689 - Risk factors for intracardiac thrombus in patients with recent ischaemic cerebrovascula...
6691939 - Pulmonary granulomatous reaction: talc pneumoconiosis or chronic sarcoidosis?
19952659 - Wrist fusion in posttraumatic brachial plexus palsy.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-7-20
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  -     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-7-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
Department of Internal Medicine, Academic Medical Centre, Amsterdam, The Netherlands. Electronic address:
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

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

Previous Document:  Evaluation of association between airway hyperresponsiveness, asthma control test, and asthma therap...
Next Document:  Effect of one-stop hybrid coronary revascularization on postoperative renal function and bleeding: A...