Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Department of Information Engineering, University of Padova, Padova, Italy.
Diabetes Care. 2023 Apr 1;46(4):864-867. doi: 10.2337/dc22-2260.
Continuous glucose monitoring (CGM) may be challenged by extreme conditions during cardiac surgery using hypothermic extracorporeal circulation (ECC).
We evaluated the Dexcom G6 sensor in 16 subjects undergoing cardiac surgery with hypothermic ECC, of whom 11 received deep hypothermic circulatory arrest (DHCA). Arterial blood glucose, quantified by the Accu-Chek Inform II meter, served as reference.
Intrasurgery mean absolute relative difference (MARD) of 256 paired CGM/reference values was 23.8%. MARD was 29.1% during ECC (154 pairs) and 41.6% immediately after DHCA (10 pairs), with a negative bias (signed relative difference: -13.7%, -26.6%, and -41.6%). During surgery, 86.3% pairs were in Clarke error grid zones A or B and 41.0% of sensor readings fulfilled the International Organization for Standardization (ISO) 15197:2013 norm. Postsurgery, MARD was 15.0%.
Cardiac surgery using hypothermic ECC challenges the accuracy of the Dexcom G6 CGM although recovery appears to occur thereafter.
在使用低温体外循环（ECC）的心脏手术过程中，连续血糖监测（CGM）可能会受到极端条件的挑战。
我们评估了 16 名接受低温 ECC 心脏手术的受试者中 Dexcom G6 传感器的性能，其中 11 名受试者接受深低温停循环（DHCA）。动脉血糖由 Accu-Chek Inform II 血糖仪定量，作为参考。
256 对 CGM/参考值的术中平均绝对相对差异（MARD）为 23.8%。ECC 期间的 MARD 为 29.1%（154 对），DHCA 后即刻为 41.6%（10 对），呈负偏差（符号相对差异：-13.7%、-26.6%和-41.6%）。在手术过程中，86.3%的配对值处于 Clarke 误差网格区 A 或 B，41.0%的传感器读数符合国际标准化组织（ISO）15197:2013 标准。术后，MARD 为 15.0%。
尽管此后似乎有所恢复，但使用低温 ECC 的心脏手术会影响 Dexcom G6 CGM 的准确性。
