Giordano Lucia, Perri Alessandro, Tiberi Eloisa, Sbordone Annamaria, Patti Maria Letizia, D'Andrea Vito, Vento Giovanni
Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
Department of Woman and Child Health and Public Health, Catholic University of Sacred Heart, 00168 Rome, Italy.
Diagnostics (Basel). 2023 Sep 21;13(18):3018. doi: 10.3390/diagnostics13183018.
The present study was designed to assess the feasibility and reliability of a Continuous Glucose Monitoring System (CGMS) in a population of asphyxiated neonates during therapeutic hypothermia.
This non-randomized feasibility study was conducted in the Neonatal Intensive Care Unit (NICU) facilities of Fondazione Policlinico A. Gemelli IRCSS. Infants matching the criteria for hypothermic treatment were included in this study and were connected to the CGMS (Medtronic, Northridge, CA, USA) within the first 12 h of life. Hypoglycemia was defined as a glucose value ≤ 47 mg/dL, and hyperglycemia was defined as a glucose value ≥ 180 mg/dL. Data obtained via the CGMS were compared with those obtained via a point-of-care blood glucometer (GTX).
The two measuring techniques were compared using the Modified Clarke Error Grid (MCEG). Sixteen infants were enrolled. The sensor had an average (standard deviation) duration of 93 (38) h. We collected 119 pairs of glycemia values (CGMVs) from the CGMS vs. GTX measurements. The CGMS detected twenty-five episodes of hypoglycemia and three episodes of hyperglycemia. All the CGMVs indicating hyperglycemia matched with the blood sample taken via the point-of-care glucometer.
The use of a CGMS would be useful as it could detect more episodes of disglycemia than standard care. Our data show poor results in terms of the accuracy of the CGMS in this particular setting.
本研究旨在评估持续葡萄糖监测系统（CGMS）在治疗性低温期间窒息新生儿群体中的可行性和可靠性。
本非随机可行性研究在Fondazione Policlinico A. Gemelli IRCSS的新生儿重症监护病房（NICU）设施中进行。符合低温治疗标准的婴儿纳入本研究，并在出生后12小时内连接到CGMS（美敦力公司，美国加利福尼亚州北岭）。低血糖定义为血糖值≤47mg/dL，高血糖定义为血糖值≥180mg/dL。将通过CGMS获得的数据与通过即时检测血糖仪（GTX）获得的数据进行比较。
使用改良的克拉克误差网格（MCEG）对两种测量技术进行比较。共纳入16例婴儿。传感器的平均（标准差）持续时间为93（38）小时。我们从CGMS与GTX测量中收集了119对血糖值（CGMVs）。CGMS检测到25次低血糖发作和3次高血糖发作。所有表明高血糖的CGMVs均与通过即时检测血糖仪采集的血样相符。
使用CGMS可能有用，因为它比标准护理能检测到更多的血糖异常发作。我们的数据显示，在这种特定情况下，CGMS的准确性较差。
