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Effects of pH, lactate, hematocrit and potassium level on the accuracy of continuous glucose monitoring (CGM) in pediatric intensive care unit

BACKGROUND: Continuous glucose monitoring (CGM) originally was developed for diabetic patients and it may be a useful tool for monitoring glucose changes in pediatric intensive care unit (PICU). Its use is, however, limited by the lack of sufficient data on its reliability at insufficient peripheral...

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Autores principales: Marics, Gábor, Koncz, Levente, Eitler, Katalin, Vatai, Barbara, Szénási, Boglárka, Zakariás, David, Mikos, Borbála, Körner, Anna, Tóth-Heyn, Péter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4372234/
https://www.ncbi.nlm.nih.gov/pubmed/25888142
http://dx.doi.org/10.1186/s13052-015-0122-x
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author Marics, Gábor
Koncz, Levente
Eitler, Katalin
Vatai, Barbara
Szénási, Boglárka
Zakariás, David
Mikos, Borbála
Körner, Anna
Tóth-Heyn, Péter
author_facet Marics, Gábor
Koncz, Levente
Eitler, Katalin
Vatai, Barbara
Szénási, Boglárka
Zakariás, David
Mikos, Borbála
Körner, Anna
Tóth-Heyn, Péter
author_sort Marics, Gábor
collection PubMed
description BACKGROUND: Continuous glucose monitoring (CGM) originally was developed for diabetic patients and it may be a useful tool for monitoring glucose changes in pediatric intensive care unit (PICU). Its use is, however, limited by the lack of sufficient data on its reliability at insufficient peripheral perfusion. We aimed to correlate the accuracy of CGM with laboratory markers relevant to disturbed tissue perfusion. PATIENTS AND METHODS: In 38 pediatric patients (age range, 0–18 years) requiring intensive care we tested the effect of pH, lactate, hematocrit and serum potassium on the difference between CGM and meter glucose measurements. Guardian® (Medtronic®) CGM results were compared to GEM 3000 (Instrumentation laboratory®) and point-of-care measurements. The clinical accuracy of CGM was evaluated by Clarke Error Grid -, Bland-Altman analysis and Pearson’s correlation. We used Friedman test for statistical analysis (statistical significance was established as a p < 0.05). RESULTS: CGM values exhibited a considerable variability without any correlation with the examined laboratory parameters. Clarke, Bland-Altman analysis and Pearson’s correlation coefficient demonstrated a good clinical accuracy of CGM (zone A and B = 96%; the mean difference between reference and CGM glucose was 1,3 mg/dL, 48 from the 780 calibration pairs overrunning the 2 standard deviation; Pearson’s correlation coefficient: 0.83). CONCLUSIONS: The accuracy of CGM measurements is independent of laboratory parameters relevant to tissue hypoperfusion. CGM may prove a reliable tool for continuous monitoring of glucose changes in PICUs, not much influenced by tissue perfusion, but still not appropriate for being the base for clinical decisions.
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spelling pubmed-43722342015-03-25 Effects of pH, lactate, hematocrit and potassium level on the accuracy of continuous glucose monitoring (CGM) in pediatric intensive care unit Marics, Gábor Koncz, Levente Eitler, Katalin Vatai, Barbara Szénási, Boglárka Zakariás, David Mikos, Borbála Körner, Anna Tóth-Heyn, Péter Ital J Pediatr Research BACKGROUND: Continuous glucose monitoring (CGM) originally was developed for diabetic patients and it may be a useful tool for monitoring glucose changes in pediatric intensive care unit (PICU). Its use is, however, limited by the lack of sufficient data on its reliability at insufficient peripheral perfusion. We aimed to correlate the accuracy of CGM with laboratory markers relevant to disturbed tissue perfusion. PATIENTS AND METHODS: In 38 pediatric patients (age range, 0–18 years) requiring intensive care we tested the effect of pH, lactate, hematocrit and serum potassium on the difference between CGM and meter glucose measurements. Guardian® (Medtronic®) CGM results were compared to GEM 3000 (Instrumentation laboratory®) and point-of-care measurements. The clinical accuracy of CGM was evaluated by Clarke Error Grid -, Bland-Altman analysis and Pearson’s correlation. We used Friedman test for statistical analysis (statistical significance was established as a p < 0.05). RESULTS: CGM values exhibited a considerable variability without any correlation with the examined laboratory parameters. Clarke, Bland-Altman analysis and Pearson’s correlation coefficient demonstrated a good clinical accuracy of CGM (zone A and B = 96%; the mean difference between reference and CGM glucose was 1,3 mg/dL, 48 from the 780 calibration pairs overrunning the 2 standard deviation; Pearson’s correlation coefficient: 0.83). CONCLUSIONS: The accuracy of CGM measurements is independent of laboratory parameters relevant to tissue hypoperfusion. CGM may prove a reliable tool for continuous monitoring of glucose changes in PICUs, not much influenced by tissue perfusion, but still not appropriate for being the base for clinical decisions. BioMed Central 2015-03-19 /pmc/articles/PMC4372234/ /pubmed/25888142 http://dx.doi.org/10.1186/s13052-015-0122-x Text en © Marics et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Marics, Gábor
Koncz, Levente
Eitler, Katalin
Vatai, Barbara
Szénási, Boglárka
Zakariás, David
Mikos, Borbála
Körner, Anna
Tóth-Heyn, Péter
Effects of pH, lactate, hematocrit and potassium level on the accuracy of continuous glucose monitoring (CGM) in pediatric intensive care unit
title Effects of pH, lactate, hematocrit and potassium level on the accuracy of continuous glucose monitoring (CGM) in pediatric intensive care unit
title_full Effects of pH, lactate, hematocrit and potassium level on the accuracy of continuous glucose monitoring (CGM) in pediatric intensive care unit
title_fullStr Effects of pH, lactate, hematocrit and potassium level on the accuracy of continuous glucose monitoring (CGM) in pediatric intensive care unit
title_full_unstemmed Effects of pH, lactate, hematocrit and potassium level on the accuracy of continuous glucose monitoring (CGM) in pediatric intensive care unit
title_short Effects of pH, lactate, hematocrit and potassium level on the accuracy of continuous glucose monitoring (CGM) in pediatric intensive care unit
title_sort effects of ph, lactate, hematocrit and potassium level on the accuracy of continuous glucose monitoring (cgm) in pediatric intensive care unit
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4372234/
https://www.ncbi.nlm.nih.gov/pubmed/25888142
http://dx.doi.org/10.1186/s13052-015-0122-x
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