Elizabeth A Pollack, Lauren N Cromwell, Qianqian Zhao, Adrianna M Sage
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引用次数: 0
Abstract
Objective: To assess the accuracy of a flash glucose monitoring system (FGMS; FreeStyle Libre 2) in healthy dogs during isoflurane general anesthesia.
Methods: 6 purpose-bred Beagle dogs underwent 3 anesthetic events, 1 week apart, in a randomized crossover study. 1 of 3 mean arterial blood pressure (MAP) states were induced under isoflurane anesthesia (hypotension [MAP, ≤ 60 mm Hg], normotension [MAP, 80 to 120 mm Hg], and hypertension [MAP, ≥ 120 mm Hg]) for 40 minutes. Interstitial glucose was collected from an FGMS (applied to the dog's neck prior to anesthesia) at 0, 5, 10, 20, 30, and 40 minutes from stabilization within targeted MAP range. Whole-blood samples were collected from a lateral saphenous vein for plasma glucose measurement (blood glucose gold standard; BGGS) and via marginal lip mucosal puncture for point-of-care glucose measurement (blood glucose point-of-care; BGPOC). Shrout-Fleiss intraclass correlation and Bland-Altman analysis were performed. Accuracy was determined using human International Organization for Standardization criteria, including Parkes consensus error grid analysis.
Results: Interstitial glucose strongly correlated with BGGS and BGPOC (intraclass correlation, 0.962 and 0.953, respectively). Interstitial glucose measured higher than BGGS (median[IQR] difference 9[-2 to 20] g/dL) and lower than BGPOC (-27[-37 to -11] g/dL). Interstitial glucose BGGS increased as MAP decreased. 62.1% and 63.3% of interstitial glucose measurements were within ± 15 mg/dL when BGGS ≤ 100 mg/dL and within ± 15% of BGGS when > 100 mg/dL, respectively. However, 100% were within zones A and B of error grid analysis.
Conclusions: Despite not meeting International Organization for Standardization standards, the FreeStyle Libre 2 demonstrated clinical accuracy for monitoring glucose concentrations in anesthetized dogs.
Clinical relevance: The application of an FGMS before anesthesia may be useful for monitoring at-risk patients perioperatively.
期刊介绍:
The American Journal of Veterinary Research supports the collaborative exchange of information between researchers and clinicians by publishing novel research findings that bridge the gulf between basic research and clinical practice or that help to translate laboratory research and preclinical studies to the development of clinical trials and clinical practice. The journal welcomes submission of high-quality original studies and review articles in a wide range of scientific fields, including anatomy, anesthesiology, animal welfare, behavior, epidemiology, genetics, heredity, infectious disease, molecular biology, oncology, pharmacology, pathogenic mechanisms, physiology, surgery, theriogenology, toxicology, and vaccinology. Species of interest include production animals, companion animals, equids, exotic animals, birds, reptiles, and wild and marine animals. Reports of laboratory animal studies and studies involving the use of animals as experimental models of human diseases are considered only when the study results are of demonstrable benefit to the species used in the research or to another species of veterinary interest. Other fields of interest or animals species are not necessarily excluded from consideration, but such reports must focus on novel research findings. Submitted papers must make an original and substantial contribution to the veterinary medicine knowledge base; preliminary studies are not appropriate.