Elizabeth A Pollack, Lauren N Cromwell, Qianqian Zhao, Adrianna M Sage
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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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>Despite not meeting International Organization for Standardization standards, the FreeStyle Libre 2 demonstrated clinical accuracy for monitoring glucose concentrations in anesthetized dogs.</p><p><strong>Clinical relevance: </strong>The application of an FGMS before anesthesia may be useful for monitoring at-risk patients perioperatively.</p>","PeriodicalId":7754,"journal":{"name":"American journal of veterinary research","volume":" ","pages":""},"PeriodicalIF":1.3000,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Accuracy of a flash glucose monitoring system in healthy dogs during isoflurane anesthesia.\",\"authors\":\"Elizabeth A Pollack, Lauren N Cromwell, Qianqian Zhao, Adrianna M Sage\",\"doi\":\"10.2460/ajvr.24.08.0242\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To assess the accuracy of a flash glucose monitoring system (FGMS; FreeStyle Libre 2) in healthy dogs during isoflurane general anesthesia.</p><p><strong>Methods: </strong>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. 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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. 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引用次数: 0
摘要
目的：评价瞬时血糖监测系统（FGMS）的准确性；异氟醚全身麻醉下健康犬自由式自由搏动2)方法：在一项随机交叉研究中，6只专用饲养的Beagle犬接受了3次麻醉，间隔1周。异氟醚麻醉诱导3种平均动脉血压（MAP）状态中的1种（低血压[MAP，≤60 mm Hg]，正常血压[MAP， 80 ~ 120 mm Hg]，高血压[MAP，≥120 mm Hg]）持续40分钟。在稳定在目标MAP范围内的0、5、10、20、30和40分钟，从FGMS（麻醉前应用于狗的颈部）收集间质葡萄糖。取外侧隐静脉全血测定血糖(血糖金标准；BGGS)和通过边缘唇粘膜穿刺进行即时血糖测量(即时血糖；BGPOC)。shroutr - fleiss类内相关及Bland-Altman分析。使用人类国际标准化组织标准确定准确性，包括帕克斯共识误差网格分析。结果：间质糖与BGGS、BGPOC呈极显著相关（类内相关系数分别为0.962、0.953）。间质葡萄糖高于BGGS（中位[IQR]差9[-2至20]g/dL），低于BGPOC（-27[-37至-11]g/dL）。间质葡萄糖BGGS随MAP降低而升高。当BGGS≤100 mg/dL时，62.1%和63.3%的间质葡萄糖测量值在±15 mg/dL范围内，当BGGS≤100 mg/dL时，测量值在±15%范围内。然而，100%都在误差网格分析的A区和B区。结论：尽管不符合国际标准化组织的标准，FreeStyle Libre 2在监测麻醉犬的血糖浓度方面表现出临床准确性。临床意义：麻醉前应用FGMS可能有助于围手术期监测高危患者。
Accuracy of a flash glucose monitoring system in healthy dogs during isoflurane anesthesia.
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.
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