The Ohio State University College of Nursing, The Ohio State University Medical Center, Columbus, OH, USA.
The Ohio State University College of Medicine, Columbus, OH, USA.
J Clin Endocrinol Metab. 2021 Sep 27;106(10):e4007-e4016. doi: 10.1210/clinem/dgab409.
The coronavirus disease 2019 (COVID-19) pandemic has created a need for remote blood glucose (BG) monitoring in the intensive care unit (ICU).
To evaluate feasibility and patient safety of a hybrid monitoring strategy of point-of-care (POC) BG plus continuous glucose monitor (CGM) in the ICU.
Retrospective analysis.
ICU of an academic medical center.
Patients with COVID-19 on IV insulin.
After meeting initial validation criteria, CGM was used for IV insulin titration and POC BG was performed every 6 hours or as needed.
Outcomes included frequency of POC BG, workflow, safety, and accuracy measures.
The study included 19 patients, 18 with CGM data, mean age 58 years, 89% on mechanical ventilation, 37% on vasopressors, and 42% on dialysis. The median time to CGM validation was 137 minutes (interquartile range [IQR] 114-206). During IV insulin, the median number of POC values was 7 (IQR 6-16) on day 1, and declined slightly thereafter (71% reduction compared with standard of 24/day). The median number of CGM values used nonadjunctively to titrate IV insulin was 11.5 (IQR 0, 15) on day 1 and increased thereafter. Time in range 70 to 180 mg/dL was 64 ± 23% on day 1 and 72 ± 16% on days 2 through 7, whereas time <70 mg/dL was 1.5 ± 4.1% on day 1 and <1% on days 2 through 7.
This study provides data to support that CGM using a hybrid protocol is feasible, accurate, safe, and has potential to reduce nursing and staff workload.
2019 年冠状病毒病（COVID-19）大流行需要在重症监护病房（ICU）中进行远程血糖（BG）监测。
评估 ICU 中即时检测（POC）BG 加连续血糖监测（CGM）混合监测策略的可行性和患者安全性。
回顾性分析。
学术医疗中心的 ICU。
接受静脉胰岛素治疗的 COVID-19 患者。
在满足初始验证标准后，CGM 用于静脉胰岛素滴定，POC BG 每 6 小时或按需进行。
观察指标包括 POC BG 的频率、工作流程、安全性和准确性。
研究纳入 19 例患者，18 例有 CGM 数据，平均年龄 58 岁，89%接受机械通气，37%接受升压药治疗，42%接受透析治疗。CGM 验证的中位时间为 137 分钟（四分位距 [IQR] 114-206）。在静脉胰岛素治疗期间，第 1 天 POC 值中位数为 7（IQR 6-16），此后略有下降（与标准的 24/天相比降低 71%）。第一天非辅助使用 CGM 值来滴定静脉胰岛素的中位数为 11.5（IQR 0，15），此后增加。70-180mg/dL 范围内的时间第 1 天为 64±23%，第 2-7 天为 72±16%，而第 1 天<70mg/dL 的时间为 1.5±4.1%，第 2-7 天<1%。
本研究提供的数据支持使用混合方案的 CGM 是可行的、准确的、安全的，并且有可能减少护理和员工工作量。
