Lim Hyun Ah, Kim Minjoo, Kim Na Jin, Huh Jaewon, Jeong Jin-Oh, Hwang Wonjung, Choi Hoon
Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
J Clin Med. 2024 Oct 16;13(20):6169. doi: 10.3390/jcm13206169.
Perioperative dysglycemia is associated with negative surgical outcomes, including increased risk of infections and longer hospital stays. Continuous glucose monitoring (CGM) provides real-time glucose data, potentially improving glycemic control during surgery. However, the performance of CGM in the intraoperative environment has not been well established. This scoping review aimed to evaluate the performance of CGM systems during the intraoperative period, focusing on their technical reliability, accuracy, adverse device effects, and efficacy. Studies that assessed intraoperative CGM performance, focusing on technical reliability, accuracy, adverse effects, or efficacy, were included. No restrictions were placed on the study design, surgical type, participant demographics, or publication date. A comprehensive literature search was performed using PubMed, EMBASE, and the Cochrane Library, covering publications up to 12 June 2024. Two independent reviewers screened and selected the studies for inclusion based on predefined eligibility criteria. Data extraction focused on the study characteristics, CGM performance, and outcomes. Twenty-two studies were included, the majority of which were prospective cohort studies. CGM systems demonstrated a high technical reliability, with sensor survival rates above 80%. However, the accuracy varied, with some studies reporting mean or median absolute relative differences of over 15%. The adverse effects were minimal and mainly involved minor skin irritation. One randomized trial found no significant difference between CGM and point-of-care glucose monitoring for glycemic control. Although CGM has the potential to improve intraoperative glycemic management, its accuracy remains inconsistent. Future research should explore newer CGM technologies and assess their impact on surgical outcomes.
围手术期血糖异常与不良手术结局相关，包括感染风险增加和住院时间延长。持续葡萄糖监测（CGM）可提供实时血糖数据，有可能改善手术期间的血糖控制。然而，CGM在术中环境中的性能尚未得到充分证实。本综述旨在评估CGM系统在术中的性能，重点关注其技术可靠性、准确性、设备不良反应和疗效。纳入评估术中CGM性能（重点关注技术可靠性、准确性、不良反应或疗效）的研究。对研究设计、手术类型、参与者人口统计学或出版日期不设限制。使用PubMed、EMBASE和Cochrane图书馆进行了全面的文献检索，涵盖截至2024年6月12日的出版物。两名独立评审员根据预先确定的纳入标准筛选并选择纳入研究。数据提取重点关注研究特征、CGM性能和结局。共纳入22项研究，其中大多数为前瞻性队列研究。CGM系统显示出较高的技术可靠性，传感器存活率超过80%。然而，准确性各不相同，一些研究报告的平均或中位数绝对相对差异超过15%。不良反应轻微，主要包括轻微皮肤刺激。一项随机试验发现，CGM与即时血糖监测在血糖控制方面无显著差异。尽管CGM有改善术中血糖管理的潜力，但其准确性仍不一致。未来的研究应探索更新的CGM技术，并评估它们对手术结局的影响。
