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糖尿病住院患者连续酮监测的潜在临床应用。

Potential Clinical Applications for Continuous Ketone Monitoring in the Hospitalized Patient with Diabetes.

机构信息

New York Institute of Technology College of Osteopathic Medicine, 101 Northern Blvd, Glen Head, Oyster Bay, NY, 11545, USA.

Division of Endocrinology and Metabolism, Renaissance School of Medicine at Stony Brook University, 100 Nicolls Rd, Stony Brook, Brookhaven, NY, 11794, USA.

出版信息

Curr Diab Rep. 2022 Oct;22(10):501-510. doi: 10.1007/s11892-022-01489-6. Epub 2022 Aug 19.

Abstract

PURPOSE OF REVIEW

In this review, the authors discuss potential clinical applications for continuous ketone monitoring (CKM) in a broad continuum of clinical settings from pre-hospital care and the emergency department to acute inpatient management and post-discharge follow-up.

RECENT FINDINGS

Though in its early stages, the concept of a novel continuous ketone sensing technology exerts great potential for use in the detection and hospital management of DKA, namely to overcome diagnostic barriers associated with ketoacidosis in patients with diabetes and obtain real-time BOHB levels, which may be useful in understanding both patients' response to treatment and DKA trajectory. Peri- and intra-operative use of CKM technology can potentially be applied in a number of urgent and elective surgical procedures frequently underwent by patients with diabetes and in the observation of patients during peri-operative fasting. In transitional care management, CKM technology could potentially facilitate patients' safe transition through levels of care, following hospital discharge from a DKA episode. This evaluation of the literature presents the potential advantages of adopting CKM and integrating this technology into the care algorithm of patients at risk for ketoacidosis.

摘要

目的综述

在这篇综述中,作者讨论了连续酮监测(CKM)在从院前急救和急诊科到急性住院管理和出院后随访的广泛临床环境中的潜在临床应用。

最新发现

尽管处于早期阶段,但新型连续酮感测技术的概念在 DKA 的检测和医院管理中具有很大的应用潜力,即克服与糖尿病患者酮酸中毒相关的诊断障碍,并获得实时 BOHB 水平,这可能有助于了解患者对治疗的反应和 DKA 轨迹。围手术期和术中使用 CKM 技术可能适用于许多经常接受糖尿病患者进行的紧急和选择性手术程序,并可用于观察手术期间禁食的患者。在过渡护理管理中,CKM 技术可能有助于患者在 DKA 发作后安全过渡到不同级别的护理。对文献的评估介绍了采用 CKM 并将该技术整合到处于酮酸中毒风险患者的护理算法中的潜在优势。

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