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一种连续血管内葡萄糖监测传感器的研发

The Development of a Continuous Intravascular Glucose Monitoring Sensor.

作者信息

Crane Barry C, Barwell Nicholas P, Gopal Palepu, Gopichand Mannam, Higgs Timothy, James Tony D, Jones Christopher M, Mackenzie Alasdair, Mulavisala Krishna Prasad, Paterson William

机构信息

GlySure Ltd, Abingdon, Oxon, UK

GlySure Ltd, Abingdon, Oxon, UK.

出版信息

J Diabetes Sci Technol. 2015 Jul;9(4):751-61. doi: 10.1177/1932296815587937. Epub 2015 Jun 1.

Abstract

BACKGROUND

Glycemic control in hospital intensive care units (ICU) has been the subject of numerous research publications and debate over the past 2 decades. There have been multiple studies showing the benefit of ICU glucose control in reducing both morbidity and mortality. GlySure Ltd has developed a glucose monitor based on a diboronic acid receptor that can continuously measure plasma glucose concentrations directly in a patient's vascular system. The goal of this study was to validate the performance of the GlySure CIGM system in different patient populations.

METHODS

The GlySure Continuous Intravascular Glucose Monitoring (CIGM) System was evaluated in both the Cardiac ICU (33 patients) and MICU setting (14 patients). The sensor was placed through a custom CVC and measured the patients' blood glucose concentration every 15 seconds. Comparison blood samples were taken at 2 hourly then 4 hourly intervals and measured on a YSI 2300 STAT Plus or an i-STAT.

RESULTS

Consensus error grid analysis of the data shows that the majority of the data (88.2% Cardiac, and 95.0% MICU) fell within zone A, which is considered to be clinically accurate and all data points fell within zones A and B. The MARD of the Cardiac trial was 9.90% and the MICU trial had a MARD of 7.95%. Data analysis showed no significant differences between data generated from Cardiac and MICU patients or by time or glucose concentration.

CONCLUSIONS

The GlySure CIGM System has met the design challenges of measuring intravascular glucose concentrations in critically ill patients with acceptable safety and performance criteria and without disrupting current clinical practice. The accuracy of the data is not affected by the patients' condition.

摘要

背景

在过去20年里,医院重症监护病房(ICU)的血糖控制一直是众多研究出版物的主题和争论焦点。多项研究表明,ICU血糖控制在降低发病率和死亡率方面具有益处。GlySure有限公司开发了一种基于二硼酸受体的血糖监测仪,该监测仪能够直接在患者的血管系统中连续测量血浆葡萄糖浓度。本研究的目的是验证GlySure CIGM系统在不同患者群体中的性能。

方法

在心脏ICU(33例患者)和内科ICU(14例患者)中对GlySure连续血管内血糖监测(CIGM)系统进行评估。传感器通过定制的中心静脉导管(CVC)放置,每15秒测量一次患者的血糖浓度。每隔2小时然后每隔4小时采集对照血样,并在YSI 2300 STAT Plus或i-STAT上进行测量。

结果

对数据进行的一致性误差网格分析表明,大多数数据(心脏ICU为88.2%,内科ICU为95.0%)落在A区,该区被认为在临床上是准确的,并且所有数据点都落在A区和B区内。心脏试验的平均相对绝对误差(MARD)为9.90%,内科ICU试验的MARD为7.95%。数据分析表明,心脏ICU和内科ICU患者的数据、不同时间的数据或不同血糖浓度的数据之间均无显著差异。

结论

GlySure CIGM系统在测量危重症患者血管内葡萄糖浓度方面,已在可接受的安全性和性能标准下应对了设计挑战,且未干扰当前临床实践。数据准确性不受患者病情影响。

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