Continuous Glucose Monitoring in the Cardiac ICU: Current Use and Future Directions
Clinical Medicine Research
Volume 6, Issue 6, November 2017, Pages: 173-176
Received: Sep. 4, 2017;
Accepted: Oct. 24, 2017;
Published: Nov. 24, 2017
Views 2033 Downloads 72
Laura A. Scrimgeour, Division of Cardiothoracic Surgery, Department of Surgery, Cardiovascular Research Center, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI, USA
Brittany A. Potz, Division of Cardiothoracic Surgery, Department of Surgery, Cardiovascular Research Center, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI, USA
Frank W. Sellke, Division of Cardiothoracic Surgery, Department of Surgery, Cardiovascular Research Center, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI, USA
M. Ruhul Abid, Division of Cardiothoracic Surgery, Department of Surgery, Cardiovascular Research Center, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI, USA
Perioperative glucose control is highly important, particularly for patients undergoing cardiac surgery. Variable glucose levels before, during and after cardiac surgery lead to increased post-operative complications and patient mortality.  Current methods for intensive monitoring and treating hyperglycemia in the Intensive Care Unit (ICU) usually involve hourly glucose monitoring and continuous intravenous insulin infusions. With the advent of more accurate subcutaneous glucose monitoring systems, the role of improved glucose control with newer systems deserves consideration for widespread adoption.
Laura A. Scrimgeour,
Brittany A. Potz,
Frank W. Sellke,
M. Ruhul Abid,
Continuous Glucose Monitoring in the Cardiac ICU: Current Use and Future Directions, Clinical Medicine Research.
Vol. 6, No. 6,
2017, pp. 173-176.
Reddy, P., Duggar, B. & Butterworth, J. Blood glucose management in the patient undergoing cardiac surgery: A review. World J. Cardiol. 6, 1209–17 (2014).
Furnary, A. P., Zerr, K. J., Grunkemeier, G. L. & Starr, A. Continuous intravenous insulin infusion reduces the incidence of deep sternal wound infection in diabetic patients after cardiac surgical procedures. Ann. Thorac. Surg. 67, 352-60–2 (1999).
Furnary, A. P. et al. Continuous insulin infusion reduces mortality in patients with diabetes undergoing coronary artery bypass grafting. J. Thorac. Cardiovasc. Surg. 125, 1007–1021 (2003).
Krzych, Ł. J. & Wybraniec, M. T. Glycaemic Control in Cardiac Surgery Patients: a Double-Edged Sword. Curr. Vasc. Pharmacol. 13, 578–86 (2015).
Steil, G. M. & Agus, M. S. D. Tight glycemic control in the ICU - is the earth flat? Crit. Care 18, 159 (2014).
Wernerman, J. et al. Continuous glucose control in the ICU: report of a 2013 round table meeting. doi:10.1186/1364-8535-18-226.
Logtenberg, S. J. et al. Pre- and Postoperative Accuracy and Safety of a Real-Time Continuous Glucose Monitoring System in Cardiac Surgical Patients: A Randomized Pilot Study. Diabetes Technol. Ther. 11, 31–37 (2009).
Keenan, D. B. et al. Accuracy of the Enlite 6-Day Glucose Sensor with Guardian and Veo Calibration Algorithms. doi:10.1089/dia.2011.0199.
DeSalvo, D. & Buckingham, B. Continuous glucose monitoring: current use and future directions. Curr. Diab. Rep. 13, 657–62 (2013).
McCowen, K. C., Malhotra, A. & Bistrian, B. R. Stress-induced hyperglycemia. Crit. Care Clin. 17, 107–24 (2001).
Malmberg, K., Norhammar, A., Wedel, H. & Rydén, L. Glycometabolic State at Admission: Important Risk Marker of Mortality in Conventionally Treated Patients With Diabetes Mellitus and Acute Myocardial Infarction. Circulation 99, (1999).
Van den Berghe, G. et al. Intensive Insulin Therapy in Critically Ill Patients. N. Engl. J. Med. 345, 1359–1367 (2001).
Investigators, T. N.-S. S. Intensive versus Conventional Glucose Control in Critically Ill Patients. N. Engl. J. Med. 360, 1283–1297 (2009).
Kalmovich, B., Bar-Dayan, Y., Boaz, M. & Wainstein, J. Continuous Glucose Monitoring in Patients Undergoing Cardiac Surgery. doi: 10.1089/dia.2011.0154.
van Hooijdonk, R. T. M. et al. Point accuracy and reliability of an interstitial continuous glucose-monitoring device in critically ill patients: a prospective study. Crit. Care 19, 34 (2015).
Song, I.-K. et al. Continuous glucose monitoring system in the operating room and intensive care unit: any difference according to measurement sites? J. Clin. Monit. Comput. 31, 187–194 (2017).
Wallia, A. et al. Consensus Statement on Inpatient Use of Continuous Glucose Monitoring. J. Diabetes Sci. Technol. 193229681770615 (2017). doi:10.1177/1932296817706151.
Basu, A., Veettil, S., Dyer, R., Peyser, T. & Basu, R. Direct Evidence of Acetaminophen Interference with Subcutaneous Glucose Sensing in Humans: A Pilot Study. Diabetes Technol. Ther. 18 Suppl 2, S243-7 (2016).
Levitt, D. L., Silver, K. D. & Spanakis, E. K. Inpatient Continuous Glucose Monitoring and Glycemic Outcomes. J. Diabetes Sci. Technol. 193229681769849 (2017). doi:10.1177/1932296817698499.
Krinsley, J. S. et al. Continuous glucose monitoring in the ICU: clinical considerations and consensus. Crit. Care 21, 197 (2017).
Boom, D. T. et al. Insulin treatment guided by subcutaneous continuous glucose monitoring compared to frequent point-of-care measurement in critically ill patients: a randomized controlled trial. Crit. Care 18, 453 (2014).
Kosiborod, M. et al. Performance of the Medtronic Sentrino continuous glucose management (CGM) system in the cardiac intensive care unit. BMJ open diabetes Res. care 2, e000037 (2014).
Christiansen, M. P. et al. Accuracy of a Fourth-Generation Subcutaneous Continuous Glucose Sensor. Diabetes Technol. Ther. dia. 2017. 0087 (2017). doi:10.1089/dia.2017.0087.
van Steen, S. C. J. et al. The Clinical Benefits and Accuracy of Continuous Glucose Monitoring Systems in Critically Ill Patients-A Systematic Scoping Review. Sensors (Basel). 17, (2017).