在 ICU 中进行连续血糖监测与常规血糖监测的比较：一项随机对照试验。
Continuous glucose monitoring versus conventional glucose monitoring in the ICU: A randomized controlled trial.
机构信息
Department of Critical Care Medicine, The Fourth Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Department of Anesthesiology, The Fourth Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China; Department of Anesthesiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
出版信息
J Crit Care. 2024 Dec;84:154894. doi: 10.1016/j.jcrc.2024.154894. Epub 2024 Aug 5.
PURPOSE
This study evaluated the clinical utility of continuous glucose monitoring system (CGMS) in critically ill patients.
METHODS
In this randomized controlled trial, we randomly assigned critically ill participants with diabetes or stress-induced hyperglycemia to the CGMS group (n = 48) or to the conventional point-of-care monitoring (POCM) group (n = 48). The glucose values and clinical outcome were compared between the two group. The primary endpoint was 28-day mortality after intensive care unit admission.
RESULTS
The 28-day mortality was not significantly different between the CGMS and POCM group (20.8% vs 31.3%, P = 0.25). The mean glucose, time-weighted average glucose, glucose standard deviation and time in range (3.9-10.0) were significantly improved in the CGMS group (all P < 0.05).
CONCLUSION
Compared with conventional POCM, CGMS did not decrease the 28-day mortality in critically ill participants with diabetes or stress-induced hyperglycemia. But CGMS may improve the glycemic control and may be increasingly used in critically ill patients.
目的
本研究评估了连续血糖监测系统（CGMS）在危重症患者中的临床应用价值。
方法
在这项随机对照试验中，我们将患有糖尿病或应激性高血糖的危重症患者随机分配至 CGMS 组（n=48）或常规即时检测监测（POCM）组（n=48）。比较两组的血糖值和临床结局。主要终点为重症监护病房（ICU）入住后 28 天的死亡率。
结果
CGMS 组和 POCM 组 28 天死亡率无显著差异（20.8% vs 31.3%，P=0.25）。CGMS 组的平均血糖、时间加权平均血糖、血糖标准差和达标时间（3.9-10.0）均显著改善（均 P<0.05）。
结论
与常规 POCM 相比，CGMS 并未降低糖尿病或应激性高血糖危重症患者 28 天死亡率。但 CGMS 可能改善血糖控制，在危重症患者中的应用可能会日益增多。
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