Pollack Elizabeth A, Cromwell Lauren N, Zhao Qianqian, Sage Adrianna M
Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI.
Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI.
Am J Vet Res. 2024 Dec 20;86(2). doi: 10.2460/ajvr.24.08.0242. Print 2025 Feb 1.
To assess the accuracy of a flash glucose monitoring system (FGMS; FreeStyle Libre 2) in healthy dogs during isoflurane general anesthesia.
6 purpose-bred Beagle dogs underwent 3 anesthetic events, 1 week apart, in a randomized crossover study. 1 of 3 mean arterial blood pressure (MAP) states were induced under isoflurane anesthesia (hypotension [MAP, ≤ 60 mm Hg], normotension [MAP, 80 to 120 mm Hg], and hypertension [MAP, ≥ 120 mm Hg]) for 40 minutes. Interstitial glucose was collected from an FGMS (applied to the dog's neck prior to anesthesia) at 0, 5, 10, 20, 30, and 40 minutes from stabilization within targeted MAP range. Whole-blood samples were collected from a lateral saphenous vein for plasma glucose measurement (blood glucose gold standard; BGGS) and via marginal lip mucosal puncture for point-of-care glucose measurement (blood glucose point-of-care; BGPOC). Shrout-Fleiss intraclass correlation and Bland-Altman analysis were performed. Accuracy was determined using human International Organization for Standardization criteria, including Parkes consensus error grid analysis.
Interstitial glucose strongly correlated with BGGS and BGPOC (intraclass correlation, 0.962 and 0.953, respectively). Interstitial glucose measured higher than BGGS (median[IQR] difference 9[-2 to 20] g/dL) and lower than BGPOC (-27[-37 to -11] g/dL). Interstitial glucose BGGS increased as MAP decreased. 62.1% and 63.3% of interstitial glucose measurements were within ± 15 mg/dL when BGGS ≤ 100 mg/dL and within ± 15% of BGGS when > 100 mg/dL, respectively. However, 100% were within zones A and B of error grid analysis.
Despite not meeting International Organization for Standardization standards, the FreeStyle Libre 2 demonstrated clinical accuracy for monitoring glucose concentrations in anesthetized dogs.
The application of an FGMS before anesthesia may be useful for monitoring at-risk patients perioperatively.
评估闪光葡萄糖监测系统（FGMS；FreeStyle Libre 2）在异氟烷全身麻醉期间对健康犬的准确性。
在一项随机交叉研究中，6只专门培育的比格犬相隔1周接受3次麻醉事件。在异氟烷麻醉下诱导出3种平均动脉血压（MAP）状态之一（低血压[MAP≤60 mmHg]、正常血压[MAP 80至120 mmHg]和高血压[MAP≥120 mmHg]）并持续40分钟。在达到目标MAP范围并稳定后，于0、5、10、20、30和40分钟从FGMS（麻醉前应用于犬颈部）采集组织间液葡萄糖。从外侧隐静脉采集全血样本用于测量血浆葡萄糖（血糖金标准；BGGS），并通过边缘唇黏膜穿刺采集用于即时检测血糖（即时检测血糖；BGPOC）。进行Shrout-Fleiss组内相关分析和Bland-Altman分析。使用人类国际标准化组织标准确定准确性，包括Parkes共识误差网格分析。
组织间液葡萄糖与BGGS和BGPOC高度相关（组内相关性分别为0.962和0.953）。组织间液葡萄糖测量值高于BGGS（中位数[四分位间距]差异为9[-2至20]mg/dL）且低于BGPOC（-27[-37至-11]mg/dL）。随着MAP降低，组织间液葡萄糖与BGGS的差异增大。当BGGS≤100 mg/dL时，62.1%的组织间液葡萄糖测量值在±15 mg/dL范围内，当BGGS>100 mg/dL时，63.3%的测量值在BGGS的±15%范围内。然而，100%的测量值在误差网格分析的A区和B区内。
尽管未达到国际标准化组织标准，但FreeStyle Libre 2在监测麻醉犬的葡萄糖浓度方面显示出临床准确性。
麻醉前应用FGMS可能有助于围手术期监测高危患者。
