title: Continuous Glucose Monitoring in Patients Undergoing Extracorporeal Ventricular Assist Therapy.
abstract: BACKGROUND
  Dysregulations of blood glucose (BG) are associated with adverse outcome in critical illness; controlling BG to target appears to improve outcome. Since BG-control is challenging in daily intensive care practice BG-control remains poor especially in patients with rapidly fluctuating BG. To improve BG-control and to avoid deleterious hypoglycemia, automated online-measurement tools are advocated. We thus evaluated the point-accuracy of the subcutaneous Sentrino® Continuous Glucose Monitoring System (CGM, Medtronic Diabetes, Northridge, California) in patients undergoing extracorporeal cardiac life support (ECLS) for cardiogenic shock.
  
  
  METHODS
  Management of BG was performed according to institute's standard aiming at BG-levels between 100-145 mg/dl. CGM-values were recorded without taking measures into therapeutic account. Point-accuracy in comparison to intermittent BG-measurement by the ABL-blood-gas analyzer was determined.
  
  
  RESULTS
  CGM (n = 25 patients) correlated significantly with ABL-values (r = 0.733, p<0.001). Mean error from standard was 15.0 mg/dl (11.9%). 44.2% of the readings were outside a 15% range around ABL-values. In one of 635 paired data-points, ABL revealed hypoglycemia (BG 32 mg/dl) whereas CGM did not show hypoglycemic values (132mg/dl).
  
  
  CONCLUSIONS
  CGM reveals minimally invasive BG-values in critically ill adults with dynamically impaired tissue perfusion. Because of potential deviations from standard, CGM-readings must be interpreted with caution in specific ICU-populations.
authors.affiliation: Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Antje
authors.initials: A
authors.lastname: Gottschalk
authors.affiliation: Department of Cardiothoracic Surgery, Division of Cardiac Surgery, University Hospital Münster, Münster, Germany.
authors.forename: Henryk A
authors.initials: HA
authors.lastname: Welp
authors.affiliation: Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Laura
authors.initials: L
authors.lastname: Leser
authors.affiliation: Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Lanckohr
authors.affiliation: Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Carola
authors.initials: C
authors.lastname: Wempe
authors.affiliation: Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Björn
authors.initials: B
authors.lastname: Ellger
mesh_terms: D000368:Aged; D015190:Blood Glucose Self-Monitoring; D003710:Demography; D005260:Female; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis