Performance of Subcutaneous Continuous Glucose Monitoring in Adult Critically Ill Patients Receiving Vasopressor Therapy
Authors' conclusion
In our ICU cohort of patients receiving vasopressor infusion, subcutaneous CGM demonstrated acceptable overall numerical and clinical accuracy. However, suboptimal accuracy may occur outside glucose ranges of 6-10 mmol/L (108-180 mg/dL), during higher dose vasopressor infusion, and during the first 36 h after CGM start.
Study context
- Population
- Adult ICU patients receiving mechanical ventilation, IV insulin infusion and vasopressor therapy; 18 with T2D; median (IQR) maximum noradrenaline equivalent infusion rate 0.18 (0.08–0.33) µg/kg/min2,946 paired samples
- Participants
- 40 patients
- Comparison
- Continuous glucose monitoring (CGM) vs arterial blood glucose
- Outcome
- Numerical accuracy by mean absolute relative difference (MARD) vs ABG; MARD <14% acceptable
Performance
As reported in the abstract
Accuracy vs ABG
| Test or model | Value | Mean absolute relative difference (MARD) | CGM readings within Clarke Error Grid (CEG) zones A and B |
|---|---|---|---|
| CGM | 12.7% (95% CI 10.7–15.3) | 12.7% | 99.8% |
CGM
Value12.7% (95% CI 10.7–15.3)
Mean absolute relative difference (MARD)12.7%
CGM readings within Clarke Error Grid (CEG) zones A and B99.8%
Further findings
MARD by arterial blood glucose (ABG) strata and noradrenaline dose
- MARD ≥14% when ABG outside target range (6-10 mmol/L [108-180 mg/dL]) and with noradrenaline equivalent infusion rates above 0.10 µg/kg/min
MARD over time since CGM start
- Accuracy improved with time, MARD <14% after 36 h
Feasibility: interrupted sensor readings due to signal loss
- Episodes of interrupted sensor readings
- 4
- Duration of interruptions
- 5 to 20 min
Safety
Skin reactions related to sensor insertion or sensor adhesives (tolerability)
- No skin reaction related to sensor insertion or sensor adhesives
Original publication
Performance of Subcutaneous Continuous Glucose Monitoring in Adult Critically Ill Patients Receiving Vasopressor Therapy. Diabetes Technol Ther. Published 31 May 2024. doi:10.
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