title: Results of a near continuous glucose monitoring technology in surgical intensive care and trauma.
abstract: Near-continuous glucose monitoring is expected to increase time in range (TIR) of 80-120mg/dL and to avoid hypoglycemia without increasing workload. We investigated a near-continuous glucose monitor in surgical critically ill and trauma patients.
  
  
  
  Patients were enrolled at a surgical intensive care unit associated with a level 1 trauma center. Glucose measurements were compared to the gold standard Yellow Springs Instrument (YSI). The technology withdraws 0.13mL of blood every 15min from a central venous line, centrifuges the sample, and uses mid-infrared spectroscopy to measure glucose. We plotted a Clarke Error Grid, calculated Mean Absolute Relative Deviation (MARD) to analyze trend accuracy, and we present a Bland Altman plot of device versus standard glucose measurements.
  
  
  
  24 patients were enrolled. One patient was withdrawn due to poor blood return from central venous line. A total of 347 glucose measurements from 23 patients were compared to the gold standard. 94.8% of the data points were in zone A of the Clarke Error Grid and 5.2% in zone B. The MARD was 8.02%. The majority of data points achieved the benchmark for accuracy. The remaining 5.2% are clinically benign. The MARD was below 10%. The Bland Altman plot shows good agreement between the device and reference glucose measurements. There were no device related adverse events.
  
  
  
  Our data suggests that near continuous monitoring via infrared spectroscopy is safe and accurate for use in critically ill surgical and trauma patients. A large scale multi-center study is underway to confirm these findings.
authors.affiliation: Acute and Critical Care Surgery, Washington University in St. Louis, St. Louis, MO, United States. Electronic address: nohrae@wudosis.wustl.edu.
authors.forename: Eden
authors.initials: E
authors.lastname: Nohra
authors.affiliation: Acute and Critical Care Surgery, Washington University in St. Louis, St. Louis, MO, United States.
authors.forename: Sara
authors.initials: S
authors.lastname: Buckman
authors.affiliation: Acute and Critical Care Surgery, Washington University in St. Louis, St. Louis, MO, United States.
authors.forename: Kelly
authors.initials: K
authors.lastname: Bochicchio
authors.affiliation: Acute and Critical Care Surgery, Washington University in St. Louis, St. Louis, MO, United States.
authors.forename: Jad
authors.initials: J
authors.lastname: Chamieh
authors.affiliation: Acute and Critical Care Surgery, Washington University in St. Louis, St. Louis, MO, United States.
authors.forename: Stacey
authors.initials: S
authors.lastname: Reese
authors.affiliation: Acute and Critical Care Surgery, Washington University in St. Louis, St. Louis, MO, United States.
authors.forename: Corinne
authors.initials: C
authors.lastname: Merrill
authors.affiliation: Acute and Critical Care Surgery, Washington University in St. Louis, St. Louis, MO, United States.
authors.forename: Douglas
authors.initials: D
authors.lastname: Schuerer
authors.affiliation: Acute and Critical Care Surgery, Washington University in St. Louis, St. Louis, MO, United States.
authors.forename: Grant V
authors.initials: GV
authors.lastname: Bochicchio
mesh_terms: D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D062905:Central Venous Catheters; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D011446:Prospective Studies; D044469:Racial Groups; D013055:Spectrophotometry, Infrared; D014947:Wounds and Injuries / Q000097:blood; D055815:Young Adult
chemical_list: D001786:Blood Glucose
keywords: Accuracy; Blood glucose meter; Continuous glucose monitoring; Glucose control; Near-infrared spectroscopy; Surgical intensive care