Continuous Glucose Monitoring in the Intensive Care Unit During the COVID-19 Pandemic.
Continuous Glucose Monitoring in the Intensive Care Unit During the COVID-19 Pandemic.
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DOI：
10.2337/dc20-2219
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发表时间：
2021-03
期刊：
影响因子：
16.2
通讯作者：
Pasquel FJ
中科院分区：
文献类型：
--
作者：
Agarwal S;Mathew J;Davis GM;Shephardson A;Levine A;Louard R;Urrutia A;Perez-Guzman C;Umpierrez GE;Peng L;Pasquel FJ
实时连续血糖监测（rtCGM）对住院危重患者有希望；然而，需要真实世界的数据。我们对 Montefiore 医疗中心确诊的 2019 冠状病毒病 (COVID-19) 感染和血糖变异性的重症监护病房 (ICU) 患者进行了 Dexcom G6 CGM。我们使用护理点 (POC) 葡萄糖-CGM 配对对住院患者 CGM 准确性进行分析，并纳入患者进行分析，无论临床状态如何。我们纳入了 11 名 CGM 患者：8 名接受连续胰岛素输注 (CII)，8 名接受血管升压药，8 名插管，4 名接受大剂量糖皮质激素，6 名接受肾脏替代治疗，2 名接受 anasarca。平均值的准确度为 12.58%，中位绝对相对差的准确度为 6.3%。 CGM 将 CII 患者的 POC 测试减少了约 60%。在危重病期间 rtCGM 的真实世界初步分析中，我们证明了 POC 血糖测试频率的早期可行性、相当高的准确性和有意义的降低。
Real-time continuous glucose monitoring (rtCGM) in critically ill hospitalized patients holds promise; however, real-world data are needed. We placed Dexcom G6 CGM on intensive care unit (ICU) patients at Montefiore Medical Center with confirmed coronavirus disease 2019 (COVID-19) infection and glycemic variability. We analyzed inpatient CGM accuracy using point-of-care (POC) glucose–CGM matched pairs and included patients for analysis regardless of clinical status. We included 11 patients with CGM: 8 on continuous insulin infusion (CII), 8 on vasopressors, 8 intubated, 4 on high-dose glucocorticoids, 6 on renal replacement therapy, and 2 with anasarca. Accuracy was 12.58% for mean and 6.3% for median absolute relative difference. CGM reduced POC testing by ∼60% for patients on CII. In this real-world preliminary analysis of rtCGM during critical illness, we demonstrate early feasibility, considerable accuracy, and meaningful reduction in the frequency of POC glucose testing.
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