Perioperative characteristics of the accuracy of subcutaneous continuous glucose monitoring - pilot study in neurosurgery and cardiac surgery -
Perioperative characteristics of the accuracy of subcutaneous continuous glucose monitoring - pilot study in neurosurgery and cardiac surgery -
复制标题
皮下连续血糖监测准确性的围手术期特征 - 神经外科和心脏外科的初步研究 -
DOI：
10.1089/dia.2018.0140
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发表时间：
2018
影响因子：
5.4
通讯作者：
Kawamata M *
中科院分区：
文献类型：
--
作者：
Sugiyama Y*;Wakabayashi R*;Urasawa M;Maruyama Y;Shimizu S;Kawamata M *
目的：探讨神经外科和心脏外科患者围手术期皮下动态血糖监测（SCGM）的准确性。方法：45例受试者，包括健康志愿者（n = 15）、神经外科和心脏外科患者（n = 15）。将MiniMed ™ 620 G SCGM系统的皮下传感器插入上臂，在插入传感器后的第二天，同时收集SCGM数据和血糖数据并进行比较。在心脏手术患者中，在术后第1天和第3天连续收集数据。结果：Clarke误差网格分析显示，健康志愿者和神经外科患者的SCGM系统的A区数据分别为82.7%和86.8%。健康志愿者的平均偏倚为-2.1 mg/dL，神经外科患者的平均偏倚为-8.3 mg/dL。在心脏手术中，尽管Clarke误差网格分析显示临床可接受，但65.3%的数据在A区，平均偏倚为− 23.5 mg/dL。在体外循环（CPB）过程中，个体SCGM的准确性发生变化，SCGM倾向于显示较低的血糖水平。术后第1天和第3天，准确度提高，85.0%和86.3%的数据在A区内。结论：尽管SCGM系统的准确度在围手术期临床上可接受，但传感器准确度受CPB影响，显示血糖水平较低。
Background:The aim of this study was to elucidate the characteristics of accuracy of subcutaneous continuous glucose monitoring (SCGM) in the perioperative period for neurosurgical and cardiac surgery patients.Methods:Forty-five subjects, including healthy volunteers (n= 15), neurosurgical patients (n= 15), and cardiac surgery patients (n= 15), were enrolled. A subcutaneous sensor of the MiniMed™ 620G SCGM system was inserted into the upper arm. On the day after sensor insertion, SCGM data and blood glucose data were collected simultaneously and compared. In cardiac surgery patients, data were continuously collected on postoperative day (POD) 1 and POD 3. Clarke error grid analysis and Bland–Altman analysis were performed to assess the accuracy of SCGM.Results:Clarke error grid analysis showed clinical acceptance of the SCGM system with 82.7% and 86.8% of the data being within zone A for healthy volunteers and neurosurgical patients, respectively. Mean biases were −2.1 mg/dL in healthy volunteers and −8.3 mg/dL in neurosurgical patients. In cardiac surgery, although Clarke error grid analysis showed clinical acceptance, 65.3% of the data were within zone A and mean bias was −23.5 mg/dL. Changes in accuracy of SCGM in individuals occurred during cardiopulmonary bypass (CPB), and SCGM tended to show a lower glucose level. On POD 1 and POD 3, the accuracy improved, and 85.0% and 86.3% of the data were within zone A.Conclusions:Although the accuracy of the SCGM system was clinically acceptable in the perioperative period, sensor accuracy was affected by CPB and showed lower glucose levels.