Real-time continuous glucose monitoring versus conventional glucose monitoring in critically ill patients: a systematic review study protocol

Objective: The use of remote real-time continuous glucose monitoring (CGM) in the hospital has rapidly emerged to preserve personal protective equipment (PPE) and reduce potential exposures during COVID-19. Design and Methods: We linked a hybrid CGM and point-of-care (POC) glucose testing protocol to a computerized decision support system for continuous insulin infusion (CII) and integrated a validation system for sensor glucose values into the electronic health record. We report our proof-of-concept experience in a COVID-19 ICU. Results: All nine patients required mechanical ventilation and corticosteroids. Seventy six percent of sensor values were within 20% of the reference POC glucose with an associated average reduction in POC of 63%. Mean time in range (70-180 mg/dL) was 71.4 ± 13.9%. Sensor accuracy was impacted by mechanical interferences in four patients. Conclusions: A hybrid protocol integrating real-time CGM and POC is helpful for managing critically ill patients with COVID-19 requiring insulin infusion.

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74-LB: Sudden Changes in Interstitial Glucose Sensing by Remote Real-Time Continuous Glucose Monitoring as a Marker of Hypoperfusion in Critically-Ill Patients with COVID-19

Diabetes ◽

10.2337/db21-74-lb ◽

2021 ◽

Vol 70 (Supplement 1) ◽

pp. 74-LB

Author(s):

JOI HESTER ◽

GEORGIA M. DAVIS ◽

FRANCISCO J. PASQUEL ◽

MARINA RABINOVICH ◽

NORMA POINDEXTER ◽

...

Keyword(s):

Real Time ◽

Critically Ill ◽

Continuous Glucose Monitoring ◽

Critically Ill Patients ◽

Glucose Monitoring ◽

Glucose Sensing ◽

Interstitial Glucose

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Real-Time Continuous Glucose Monitoring in Critically Ill Patients: A prospective randomized trial

Diabetes Care ◽

10.2337/dc09-1352 ◽

2009 ◽

Vol 33 (3) ◽

pp. 467-472 ◽

Cited By ~ 138

Author(s):

U. Holzinger ◽

J. Warszawska ◽

R. Kitzberger ◽

M. Wewalka ◽

W. Miehsler ◽

...

Keyword(s):

Randomized Trial ◽

Real Time ◽

Critically Ill ◽

Continuous Glucose Monitoring ◽

Critically Ill Patients ◽

Glucose Monitoring ◽

Prospective Randomized Trial

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ASSESSMENT OF THE ACCURACY OF REAL-TIME CONTINUOUS GLUCOSE MONITORING AND ITS CORRELATED FACTORS IN CRITICALLY ILL PATIENTS

Intensive Care Medicine Experimental ◽

10.1186/2197-425x-3-s1-a192 ◽

2015 ◽

Vol 3 (S1) ◽

Author(s):

MZ Lu ◽

Y Kang

Keyword(s):

Real Time ◽

Critically Ill ◽

Continuous Glucose Monitoring ◽

Critically Ill Patients ◽

Glucose Monitoring ◽

Correlated Factors

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Remote Continuous Glucose Monitoring With a Computerized Insulin Infusion Protocol for Critically Ill Patients in a COVID-19 Medical ICU: Proof of Concept

10.2337/figshare.13570862 ◽

2021 ◽

Author(s):

Georgia M. Davis ◽

Eileen Faulds ◽

Tara Walker ◽

Debbie Vigliotti ◽

Marina Rabinovich ◽

...

Keyword(s):

Real Time ◽

Critically Ill ◽

Continuous Glucose Monitoring ◽

Critically Ill Patients ◽

Insulin Infusion ◽

Point Of Care ◽

Glucose Monitoring ◽

Proof Of Concept ◽

Computerized Decision Support ◽

Glucose Testing

Objective: The use of remote real-time continuous glucose monitoring (CGM) in the hospital has rapidly emerged to preserve personal protective equipment (PPE) and reduce potential exposures during COVID-19. Design and Methods: We linked a hybrid CGM and point-of-care (POC) glucose testing protocol to a computerized decision support system for continuous insulin infusion (CII) and integrated a validation system for sensor glucose values into the electronic health record. We report our proof-of-concept experience in a COVID-19 ICU. Results: All nine patients required mechanical ventilation and corticosteroids. Seventy six percent of sensor values were within 20% of the reference POC glucose with an associated average reduction in POC of 63%. Mean time in range (70-180 mg/dL) was 71.4 ± 13.9%. Sensor accuracy was impacted by mechanical interferences in four patients. Conclusions: A hybrid protocol integrating real-time CGM and POC is helpful for managing critically ill patients with COVID-19 requiring insulin infusion.

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Remote Continuous Glucose Monitoring With a Computerized Insulin Infusion Protocol for Critically Ill Patients in a COVID-19 Medical ICU: Proof of Concept

10.2337/figshare.13570862.v2 ◽

2021 ◽

Author(s):

Georgia M. Davis ◽

Eileen Faulds ◽

Tara Walker ◽

Debbie Vigliotti ◽

Marina Rabinovich ◽

...

Keyword(s):

Real Time ◽

Critically Ill ◽

Continuous Glucose Monitoring ◽

Critically Ill Patients ◽

Insulin Infusion ◽

Point Of Care ◽

Glucose Monitoring ◽

Proof Of Concept ◽

Computerized Decision Support ◽

Glucose Testing

Objective: The use of remote real-time continuous glucose monitoring (CGM) in the hospital has rapidly emerged to preserve personal protective equipment (PPE) and reduce potential exposures during COVID-19. Design and Methods: We linked a hybrid CGM and point-of-care (POC) glucose testing protocol to a computerized decision support system for continuous insulin infusion (CII) and integrated a validation system for sensor glucose values into the electronic health record. We report our proof-of-concept experience in a COVID-19 ICU. Results: All nine patients required mechanical ventilation and corticosteroids. Seventy six percent of sensor values were within 20% of the reference POC glucose with an associated average reduction in POC of 63%. Mean time in range (70-180 mg/dL) was 71.4 ± 13.9%. Sensor accuracy was impacted by mechanical interferences in four patients. Conclusions: A hybrid protocol integrating real-time CGM and POC is helpful for managing critically ill patients with COVID-19 requiring insulin infusion.

Download Full-text