The accuracy of a continuous blood glucose monitor during surgery
The accuracy of a continuous blood glucose monitor during surgery
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DOI：
10.1213/01.ane.0000296461.26492.3c
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发表时间：
2008-01-01
影响因子：
5.7
通讯作者：
Hanazaki, Kazuhiro
中科院分区：
文献类型：
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作者：
Yamashita, Koichi;Okabayashi, Takehiro;Hanazaki, Kazuhiro
背景技术背景：严格控制血糖的方案在手术环境中可能难以实现，特别是当依赖于间歇性血糖测试时。连续血糖监测系统可促进血糖管理。在本研究中，我们比较了手术期间连续测量的血糖（STG-22（TM），Nikkiso，Tokyo，Japan）与使用常规实验室血糖仪（ABL（TM）800 FLEX（Radiometer Medical Aps，Bronshej，Den-mark）间歇获得的同步测量值。这项研究的目的是确定的连续方法在surgery.MATERIAL和METHODS的可靠性和准确性：二十九例患者预定常规手术全身麻醉参加了这项研究。麻醉诱导后，将20 G IV导管插入前臂外周静脉，并连接至连续血糖监测仪。还插入了桡动脉导管，麻醉师根据实际采血前丢弃3 mL血液的既定方案，从桡动脉导管中获取血糖估计样本。在取样后立即通过ABL（TM）800 FLEX测量血糖。结果：偏倚和一致性上下限分别为-2.6，23和-28。的下限/上限的协议的百分比误差为21%和18%，respectively.Discussion AND Conclusions：血糖测量获得连续一致的一致间歇性测量在21%以内。STG-22（TM）仍然可以用于连续跟踪变化和减少间歇测量的频率，但使用可靠设备测试样品的需求并没有消除。
BACKGROUND: Protocols for tight control of blood glucose can be difficult to achieve in the surgical setting, especially when relying upon intermittent blood glucose testing. A continuous blood glucose monitoring system can facilitate blood glucose management. In the present study, we compared blood glucose measured continuously (STG-22 (TM), Nikkiso, Tokyo, Japan), during surgery with coincident measurements obtained intermittently using a conventional laboratory glucometer (ABL (TM) 800FLEX (Radiometer Medical Aps, Bronshej, Den-mark). The goal of the study was to determine the reliability and accuracy of the continuous method during surgery.MATERIAL AND METHODS: Twenty-nine patients scheduled for routine surgery with general anesthesia were enrolled in this study. After anesthetic induction, a 20G IV catheter was inserted in a peripheral forearm vein and connected to the continuous blood glucose monitor. A radial arterial catheter was also inserted from which samples for blood glucose estimation were obtained by an anesthesiologist, following an established protocol of discarding 3 mL of blood before the actual blood sampling. Blood glucose was measured by ABL (TM) 800FLEX immediately after sampling. One hundred points of paired blood glucose values were obtained, which were compared using Bland and Altman analysis.RESULTS: Bias and upper and lower limits of agreement were -2.6, 23, and -28, respectively. The percentage error of the lower/upper limits of agreement was 21% and 18%, respectively.DISCUSSION AND CONCLUSIONS: The blood glucose measurements obtained continuously agreed with the coincident intermittent measurements within 21%. The STG-22 (TM) may still be useful for following changes continuously and reducing the frequency of intermittent measurement, but the need for testing samples with a reliable device is not eliminated.