title: Microdialysis based device for continuous extravascular monitoring of blood glucose.
abstract: Glycemic control of intensive care patients can be beneficial for this patient group but the continuous determination of their glucose concentration is challenging. Current continuous glucose monitoring systems based on the measurement of interstitial fluid glucose concentration struggle with sensitivity losses, resulting from biofouling or inflammation reactions. Their use as decision support systems for the therapeutic treatment is moreover hampered by physiological time delays as well as gradients in glucose concentration between plasma and interstitial fluid. To overcome these drawbacks, we developed and clinically evaluated a system based on microdialysis of whole blood. Venous blood is heparinised at the tip of a double lumen catheter and pumped through a membrane based micro-fluidic device where protein-free microdialysate samples are extracted. Glucose recovery as an indicator of long term stability was studied in vitro with heparinised bovine blood and remained highly stable for 72 h. Clinical performance was tested in a clinical trial in eight healthy volunteers undergoing an oral glucose tolerance test. Glucose concentrations of the new system and the reference method correlated at a level of 0.96 and their mean relative difference was 1.9 +/- 11.2%. Clinical evaluation using Clark's Error Grid analysis revealed that the obtained glucose concentrations were accurate and clinically acceptable in 99.6% of all cases. In conclusion, results of the technical and clinical evaluation suggest that the presented device delivers microdialysate samples suitable for accurate and long term stable continuous glucose monitoring in blood.
authors.affiliation: Institute of Medical Technologies and Health Management, Joanneum Research GmbH, Elisabethstrasse 11a, 8010, Graz, Austria. franz.feichtner@joanneum.at
authors.forename: Franz
authors.initials: F
authors.lastname: Feichtner
authors.forename: Roland
authors.initials: R
authors.lastname: Schaller
authors.forename: Andreas
authors.initials: A
authors.lastname: Fercher
authors.forename: Maria
authors.initials: M
authors.lastname: Ratzer
authors.forename: Martin
authors.initials: M
authors.lastname: Ellmerer
authors.forename: Johannes
authors.initials: J
authors.lastname: Plank
authors.forename: Bernd
authors.initials: B
authors.lastname: Krause
authors.forename: Thomas
authors.initials: T
authors.lastname: Pieber
authors.forename: Lukas
authors.initials: L
authors.lastname: Schaupp
mesh_terms: D000328:Adult; D015374:Biosensing Techniques / Q000295:instrumentation*; D001786:Blood Glucose / Q000032:analysis*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D008297:Male; D017551:Microdialysis / Q000295:instrumentation*; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D001786:Blood Glucose