title: Continuous glucose monitoring on the ICU using a subcutaneous sensor.
abstract: BACKGROUND
  Hypoglycemia is a frequent and feared complication of insulin therapy on the intensive care unit (ICU). Sedated patients in particular are at risk for hypoglycemia due to the absence of clinical symptoms. Furthermore, recent studies point to a correlation between the variability of blood glucose and mortality. Therefore, continuous glucose monitoring has the potential to influence outcome due to a better control of blood glucose in critically ill patients.
  
  
  METHODS
  We evaluated the efficacy, accuracy and safety of a new commercially available subcutaneous continuous glucose monitoring system (sCGM; Sentrino®, Medtronic) in a pilot study in critically ill adult patients. sCGM data were recorded for up to 72 h and values were compared with blood glucose values measured by cassette-based blood gas analyzer (BGA).
  
  
  RESULTS
  A total of 14 patients (eight male, six female), with a mean age of 62.1 ± 9.8 years, referred to the ICU after major abdominal surgery were studied. The average simplified acute physiology score (SAPS II) was 35 ± 9. Three patients had known type II diabetes. The average runtime of sensors was 44.1 ± 22.1 h. In comparison to BGA, measurement of blood glucose by sCGM revealed an accuracy of 1.5 mg/dl, and a precision of +34.2 mg/dl to -31.2 mg/dl. Linn's concordance correlation coefficient yielded 0.74 with a 95% confidence interval of 0.68-0.78. No hypoglycemic events, defined as a blood glucose level below 70 mg/dl, occurred during treatment.
  
  
  CONCLUSIONS
  sCGM monitoring via a subcutaneous sensor demonstrated high accuracy and considerable variability compared to blood gas samples, even in critically ill patients.
authors: Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, Hamburg-Eppendorf University Medical Center, Martinistr. 52, 20246, Hamburg, Germany, punke@uke.de.
authors: M A
authors: MA
authors: Punke
authors: C
authors: C
authors: Decker
authors: K
authors: K
authors: Wodack
authors: D A
authors: DA
authors: Reuter
authors: S
authors: S
authors: Kluge
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000175:diagnosis; D007328:Insulin / Q000008:administration & dosage; D015278:Intensive Care Units, Pediatric; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D010865:Pilot Projects; D011182:Postoperative Care; D015203:Reproducibility of Results; D012307:Risk Factors; D040521:Subcutaneous Tissue; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007328:Insulin