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Head-to-head comparison of two continuous glucose monitoring systems on a cardio-surgical ICU

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Abstract

In critical illness hypo-and hyperglycemia have a negative influence on patient outcome. Continuous glucose monitoring (CGM) could help in early detection of hypo-and hyperglycemia. A requirement for these new methods is an acceptable accuracy and precision in clinical practice. In this pilot study we prospectively evaluated the accuracy and precision of two CGM sensors (subcutaneous sensor: Sentrino®, Medtronic and intravasal sensor: Glucoclear®, Edwards) in 20 patients on a cardio-surgical ICU in a head to head comparison. CGM data were recorded for up to 48 h and values were compared with blood-gas-analysis (BGA) values, analysed with Bland–Altman-plots and color-coded surveillance error-grids. Shown are means ± standard deviations. In total 270/255 intravasal/subcutaneous pairs with BGA-values were analysed. The average runtime of the sensors was 28.4 ± 6.4 h. Correlation with BGA values yielded a correlation coefficient of 0.76 (subcutaneous sensor) and 0.92 (intravasal sensor). The Bland Altman Plots revealed an accuracy of 2.5 mg/dl, and a precision of + 43.0 mg/dl to − 38.0 mg/dl (subcutaneous sensor) and an accuracy of − 6.0 mg/dl, and a precision of + 12.4 mg/dl to − 24.4 mg/dl (intravasal sensor). No severe hypoglycemic event, defined as BG level below 40 mg/dl, occurred during treatment. Both sensors showed good accuracy in comparison to the BGA values, however they differ regarding precision, which in case of the subcutaneous sensor is considerable high.

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Acknowledgements

We obtained the study monitors free of charge from Edwards and Medtronic. We thank the nursing staff on the cardio-surgical ICU, Department of Intensive Care Medicine, Center of Anesthesiology and Intensive Care Medicine, Hamburg-Eppendorf University Medical Center, Hamburg, Germany for helping us to perform the study.

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Authors and Affiliations

  1. Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, Hamburg-Eppendorf University Medical Center, Martinistraße 52, 20246, Hamburg, Germany

    M. A. Punke, M. Petzoldt, D. A. Reuter & K. H. Wodack

  2. Department of Cardiovascular Surgery, University Heart Center, Hamburg-Eppendorf University Medical Center, Hamburg, Germany

    H. Reichenspurner

  3. Department of Intensive Care Medicine, Center of Anesthesiology and Intensive Care Medicine, Hamburg-Eppendorf University Medical Center, Hamburg, Germany

    C. Decker, M. Kubik & S. Kluge

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  1. M. A. Punke
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  2. C. Decker
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  3. M. Petzoldt
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  4. D. A. Reuter
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  5. K. H. Wodack
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  6. H. Reichenspurner
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  7. M. Kubik
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  8. S. Kluge
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Correspondence to M. A. Punke.

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Conflict of interest

The authors declare that they have no conflict of interest, except MP, who is a member of the Medical Advisory Board of Radiometer Medical, Copenhagen, Denmark. No author or participant has any financial interest in the subject matter, materials or equipment discussed.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Punke, M.A., Decker, C., Petzoldt, M. et al. Head-to-head comparison of two continuous glucose monitoring systems on a cardio-surgical ICU. J Clin Monit Comput 33, 895–901 (2019). https://doi.org/10.1007/s10877-018-0221-5

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  • DOI: https://doi.org/10.1007/s10877-018-0221-5

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