Continuous glucose monitoring system can improve the quality of glucose control and glucose variability compared with point-of-care measurement in critically ill patients: A randomized controlled trial.
Medicine (Baltimore)
; 97(36): e12138, 2018 Sep.
Article
em En
| MEDLINE
| ID: mdl-30200106
ABSTRACT
BACKGROUND:
The purpose of this study was to determine whether subcutaneous continuous glucose monitoring systems (CGMS) could improve glucose management in critically ill patients compared with frequent and conventional point-of-care (POC) glucose measurements.METHODS:
A total of 144 patients with an expected length of stay in the ICU of at least 72 hours and with an admission glucose or two random glucose values of >10.0âmmol/L within 24 hours after admission, were randomly assigned to the CGMS group (nâ=â74) or the conventional group (C group, nâ=â70). Both groups used the same insulin algorithm to reach the same glucose target range (8.0-10.0 mmol/L).RESULTS:
Time in range (TIR, 8.0-10.0âmmol/L), which is our primary outcome measure, was higher in the CGMS group than in the C group (51.5% vs. 29.0%, Pâ<â.001). Glucose variability (coefficient of variation, CV; standard deviation, SD; glucose lability index, and GLI) was improved by CGMS (all Pâ<â.05). Mean glucose level (MGL) (9.6 vs. 10.3âmmol/L, Pâ=â.156) and the proportion of patients with hypoglycemia did not differ between CGMS (5.4%) and C (5.7%) (Pâ=â1.000). However, duration of hypoglycemia was reduced in the CGMS group (15 vs. 28 minutes, Pâ=â.032). Clinical outcomes were similar between groups except for the fewer usage of CRRT and lower peak plasma urea nitrogen level in the CGMS group.CONCLUSION:
The use of CGMS, compared with POC glucose measurement, could improve the TIR, GV and duration of hypoglycemia.
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Base de dados:
MEDLINE
Assunto principal:
Análise Química do Sangue
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Sistemas Automatizados de Assistência Junto ao Leito
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Cuidados Críticos
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Monitorização Fisiológica
Tipo de estudo:
Clinical_trials
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article