Continuous glucose monitoring versus conventional glucose monitoring in the ICU: A randomized controlled trial

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE Journal of critical care Pub Date : 2024-08-05 DOI:10.1016/j.jcrc.2024.154894

Chen Chu , Jian Li , XiaoDong Yang , HuiJing Zhao , ZaiXian Wu , RuoXin Xu , JianLing Gao

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Abstract

Purpose

This study evaluated the clinical utility of continuous glucose monitoring system (CGMS) in critically ill patients.

Methods

In this randomized controlled trial, we randomly assigned critically ill participants with diabetes or stress-induced hyperglycemia to the CGMS group (n = 48) or to the conventional point-of-care monitoring (POCM) group (n = 48). The glucose values and clinical outcome were compared between the two group. The primary endpoint was 28-day mortality after intensive care unit admission.

Results

The 28-day mortality was not significantly different between the CGMS and POCM group (20.8% vs 31.3%, P = 0.25). The mean glucose, time-weighted average glucose, glucose standard deviation and time in range (3.9–10.0) were significantly improved in the CGMS group (all P < 0.05).

Conclusion

Compared with conventional POCM, CGMS did not decrease the 28-day mortality in critically ill participants with diabetes or stress-induced hyperglycemia. But CGMS may improve the glycemic control and may be increasingly used in critically ill patients.

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重症监护室中的连续葡萄糖监测与传统葡萄糖监测：随机对照试验。

目的：本研究评估了连续血糖监测系统（CGMS）在重症患者中的临床应用：在这项随机对照试验中，我们将患有糖尿病或应激性高血糖的重症患者随机分配到 CGMS 组（48 人）或传统的护理点监测（POCM）组（48 人）。两组的血糖值和临床结果进行了比较。主要终点是入住重症监护室后 28 天的死亡率：结果：CGMS 组和 POCM 组的 28 天死亡率无明显差异（20.8% vs 31.3%，P = 0.25）。CGMS 组的平均血糖、时间加权平均血糖、血糖标准偏差和血糖在范围内的时间（3.9-10.0）均有明显改善（均为 P 结论：CGMS 组的平均血糖、时间加权平均血糖、血糖标准偏差和血糖在范围内的时间均有明显改善：与传统的 POCM 相比，CGMS 并未降低糖尿病或应激性高血糖危重症患者的 28 天死亡率。但 CGMS 可改善血糖控制，可越来越多地用于重症患者。

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来源期刊

Journal of critical care 医学-危重病医学

CiteScore

8.60

自引率

2.70%

发文量

237

审稿时长

23 days

期刊介绍： The Journal of Critical Care, the official publication of the World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM), is a leading international, peer-reviewed journal providing original research, review articles, tutorials, and invited articles for physicians and allied health professionals involved in treating the critically ill. The Journal aims to improve patient care by furthering understanding of health systems research and its integration into clinical practice. The Journal will include articles which discuss: All aspects of health services research in critical care System based practice in anesthesiology, perioperative and critical care medicine The interface between anesthesiology, critical care medicine and pain Integrating intraoperative management in preparation for postoperative critical care management and recovery Optimizing patient management, i.e., exploring the interface between evidence-based principles or clinical insight into management and care of complex patients The team approach in the OR and ICU System-based research Medical ethics Technology in medicine Seminars discussing current, state of the art, and sometimes controversial topics in anesthesiology, critical care medicine, and professional education Residency Education.