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Reference Ranges of Glycemic Variability in Infants after Surgery—A Prospective Cohort Study

We aimed to define reference ranges of glycemic variability indices derived from continuous glucose monitoring data for non-diabetic infants during post-operative intensive care treatment after cardiac surgery procedures. We performed a prospective cohort intervention study in a pediatric intensive...

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Autores principales: Kaminska, Halla, Wieczorek, Pawel, Zalewski, Grzegorz, Malachowska, Beata, Kucharski, Przemyslaw, Fendler, Wojciech, Szarpak, Lukasz, Jarosz-Chobot, Przemyslawa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8878403/
https://www.ncbi.nlm.nih.gov/pubmed/35215390
http://dx.doi.org/10.3390/nu14040740
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author Kaminska, Halla
Wieczorek, Pawel
Zalewski, Grzegorz
Malachowska, Beata
Kucharski, Przemyslaw
Fendler, Wojciech
Szarpak, Lukasz
Jarosz-Chobot, Przemyslawa
author_facet Kaminska, Halla
Wieczorek, Pawel
Zalewski, Grzegorz
Malachowska, Beata
Kucharski, Przemyslaw
Fendler, Wojciech
Szarpak, Lukasz
Jarosz-Chobot, Przemyslawa
author_sort Kaminska, Halla
collection PubMed
description We aimed to define reference ranges of glycemic variability indices derived from continuous glucose monitoring data for non-diabetic infants during post-operative intensive care treatment after cardiac surgery procedures. We performed a prospective cohort intervention study in a pediatric intensive care unit (PICU). Non-diabetic infants aged 0–12 months after corrective cardiovascular surgery procedures were fitted upon arrival to the PICU with a continuous glucose monitoring system (iPro2, Medtronic, Minneapolis, MN, USA). Thirteen glycemic variability indices were calculated for each patient. Complete recordings of 65 patients were collected on the first postoperative day. During the first three postsurgical days 5%, 24% and 43% of patients experienced at least one hypoglycemia episode, and 40%, 10% and 15%—hyperglycemia episode, respectively, in each day. Due to significant differences between the first postoperative day (mean glycemia 130 ± 31 mg/dL) and the second and third day (105 ± 18 mg/dL, 101 ± 22.2 mg/dL; p < 0.0001), we proposed two separate reference ranges—for the acute and steady state patients. Thus, for individual glucose measurements, we proposed a reference range between 85 and 229 mg/dL and 69 and 149 mg/dL. For the mean daily glucose level, ranges between 122 and 137 mg/dL and 95 and 110 mg/dL were proposed. In conclusion, rt-CGM revealed a very high likelihood of hyperglycemia in the first postsurgical day. The widespread use of CGM systems in a pediatric ICU setting should be considered as a safeguard against dysglycemic episodes; however, reference ranges for those patients should be different to those used in diabetes care.
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spelling pubmed-88784032022-02-26 Reference Ranges of Glycemic Variability in Infants after Surgery—A Prospective Cohort Study Kaminska, Halla Wieczorek, Pawel Zalewski, Grzegorz Malachowska, Beata Kucharski, Przemyslaw Fendler, Wojciech Szarpak, Lukasz Jarosz-Chobot, Przemyslawa Nutrients Article We aimed to define reference ranges of glycemic variability indices derived from continuous glucose monitoring data for non-diabetic infants during post-operative intensive care treatment after cardiac surgery procedures. We performed a prospective cohort intervention study in a pediatric intensive care unit (PICU). Non-diabetic infants aged 0–12 months after corrective cardiovascular surgery procedures were fitted upon arrival to the PICU with a continuous glucose monitoring system (iPro2, Medtronic, Minneapolis, MN, USA). Thirteen glycemic variability indices were calculated for each patient. Complete recordings of 65 patients were collected on the first postoperative day. During the first three postsurgical days 5%, 24% and 43% of patients experienced at least one hypoglycemia episode, and 40%, 10% and 15%—hyperglycemia episode, respectively, in each day. Due to significant differences between the first postoperative day (mean glycemia 130 ± 31 mg/dL) and the second and third day (105 ± 18 mg/dL, 101 ± 22.2 mg/dL; p < 0.0001), we proposed two separate reference ranges—for the acute and steady state patients. Thus, for individual glucose measurements, we proposed a reference range between 85 and 229 mg/dL and 69 and 149 mg/dL. For the mean daily glucose level, ranges between 122 and 137 mg/dL and 95 and 110 mg/dL were proposed. In conclusion, rt-CGM revealed a very high likelihood of hyperglycemia in the first postsurgical day. The widespread use of CGM systems in a pediatric ICU setting should be considered as a safeguard against dysglycemic episodes; however, reference ranges for those patients should be different to those used in diabetes care. MDPI 2022-02-10 /pmc/articles/PMC8878403/ /pubmed/35215390 http://dx.doi.org/10.3390/nu14040740 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kaminska, Halla
Wieczorek, Pawel
Zalewski, Grzegorz
Malachowska, Beata
Kucharski, Przemyslaw
Fendler, Wojciech
Szarpak, Lukasz
Jarosz-Chobot, Przemyslawa
Reference Ranges of Glycemic Variability in Infants after Surgery—A Prospective Cohort Study
title Reference Ranges of Glycemic Variability in Infants after Surgery—A Prospective Cohort Study
title_full Reference Ranges of Glycemic Variability in Infants after Surgery—A Prospective Cohort Study
title_fullStr Reference Ranges of Glycemic Variability in Infants after Surgery—A Prospective Cohort Study
title_full_unstemmed Reference Ranges of Glycemic Variability in Infants after Surgery—A Prospective Cohort Study
title_short Reference Ranges of Glycemic Variability in Infants after Surgery—A Prospective Cohort Study
title_sort reference ranges of glycemic variability in infants after surgery—a prospective cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8878403/
https://www.ncbi.nlm.nih.gov/pubmed/35215390
http://dx.doi.org/10.3390/nu14040740
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