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Accuracy of a real-time continuous glucose monitoring system in children with septic shock: A pilot study

Sumant Prabhudesai1, Amruta Kanjani2, Isha Bhagat3

  • 1Royal Manchester Children's Hospital, Manchester, UK.

Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine
|January 6, 2016
PubMed

Insights

Continuous glucose monitoring systems (CGMS) offer a fairly accurate estimate of blood glucose in children with septic shock. Accuracy may be a concern at glucose extremes, warranting further study.

Area of Science:

  • Pediatric Intensive Care
  • Endocrinology
  • Medical Devices

Background:

  • Septic shock in children presents significant challenges in glucose management.
  • Accurate real-time glucose monitoring is crucial for timely intervention.

Purpose of the Study:

  • To evaluate the accuracy of a real-time continuous glucose monitoring system (CGMS) in pediatric patients with septic shock.
  • To compare interstitial glucose readings from CGMS with laboratory blood glucose measurements.

Main Methods:

  • Prospective, observational study including children (30 days to 18 years) with septic shock.
  • Simultaneous collection of interstitial glucose (CGMS) and blood glucose (BG) readings.
  • Statistical analysis included correlation, Clarke's error grid, and receiver operating characteristics (ROC) curve analysis.

Main Results:

  • A total of 235 paired BG-CGMS readings were analyzed from 19 children.
  • CGMS showed a correlation coefficient of 0.61 (P < 0.001) with BG, with a median relative absolute difference of 17.29%.
  • 94.5% of readings fell within clinically acceptable zones (A and B) on Clarke's error grid. Accuracy was not impacted by clinical variables like edema or vasopressors. ROC analysis indicated good predictive value for hypoglycemia (AUC=0.85) and hyperglycemia (AUC=0.87).

Conclusions:

  • Real-time CGMS provides a reasonably accurate estimate of blood glucose in pediatric septic shock.
  • CGMS performance is robust across various clinical conditions, but accuracy at glucose extremes requires attention.
  • Larger studies are recommended to confirm CGMS utility for detecting hypoglycemia and hyperglycemia.
Abstract

Keywords:
Childrencontinuous glucose monitoring systemseptic shock

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