title: Real-time continuous glucose monitoring versus conventional glucose monitoring in critically ill patients: a systematic review study protocol.
abstract: BACKGROUND
  Stress-induced hyperglycaemia, which has been shown to be associated with an unfavourable prognosis, is common among critically ill patients. Additionally, it has been reported that hypoglycaemia and high glucose variabilities are also associated with adverse outcomes. Thus, continuous glucose monitoring (CGM) may be the optimal method to detect severe hypoglycaemia, hyperglycaemia and decrease glucose excursion. However, the overall accuracy and reliability of CGM systems and the effects of CGM systems on glucose control and prognosis in critically ill patients remain inconclusive. Therefore, we will conduct a systematic review and meta-analysis to clarify the associations between CGM systems and clinical outcome.
  
  
  METHODS
  We will search PubMed, EMBASE and the Cochrane Library from inception to October 2014. Studies comparing CGM systems with any other glucose monitoring methods in critically ill patients will be eligible for our meta-analysis. The primary endpoints include the incidence of hypoglycaemia and hyperglycaemia, mean glucose level, and percentage of time within the target range. The second endpoints include intensive care unit (ICU) mortality, hospital mortality, duration of mechanical ventilation, length of ICU and hospital stay, and the Pearson correlation coefficient and the results of error grid analysis. In addition, we will record all complications (eg, acquired infections) in control and intervention groups and local adverse events in intervention groups (eg, bleeding or infections).
  
  
  BACKGROUND
  Ethics approval is not required as this is a protocol for a systematic review. The findings will be disseminated in a peer-reviewed journal and presented at a relevant conference.
  
  
  BACKGROUND
  PROSPERO registration number: CRD42014013488.
authors.affiliation: Department of Emergency Medicine, Second Affiliated Hospital, School of Medicine and Institute of Emergency Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Weidong
authors.initials: W
authors.lastname: Zhu
authors.affiliation: Department of Emergency Medicine, Second Affiliated Hospital, School of Medicine and Institute of Emergency Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Libing
authors.initials: L
authors.lastname: Jiang
authors.affiliation: Department of Emergency Medicine, Second Affiliated Hospital, School of Medicine and Institute of Emergency Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Shouyin
authors.initials: S
authors.lastname: Jiang
authors.affiliation: Department of Emergency Medicine, Second Affiliated Hospital, School of Medicine and Institute of Emergency Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Yuefeng
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Department of Emergency Medicine, Second Affiliated Hospital, School of Medicine and Institute of Emergency Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Mao
authors.initials: M
authors.lastname: Zhang
mesh_terms: D001786:Blood Glucose / Q000032:analysis*; D016638:Critical Illness; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis*; D007362:Intensive Care Units; D015201:Meta-Analysis as Topic; D008991:Monitoring, Physiologic / Q000379:methods*; D015203:Reproducibility of Results; D012107:Research Design; D000078202:Systematic Reviews as Topic
chemical_list: D001786:Blood Glucose
keywords: continuous monitoring; glucose; hyperglycemia; hypoglycemia; mortality