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Evaluation of continuous flash glucose monitoring in a pediatric ICU setting

Eirini Kotzapanagiotou1, Eleni Tsotridou2, Eleni Volakli1

  • 1Pediatric Intensive Care Unit, Hippokratio General Hospital, Thessaloniki, Greece.

Journal of Clinical Monitoring and Computing
|September 5, 2019
PubMed

Insights

Flash glucose monitoring (FGM) in pediatric ICUs showed underestimation of glucose levels. While well-tolerated, the FreeStyle Libre system requires further accuracy improvements for critically ill children.

Area of Science:

  • Pediatric Intensive Care Medicine
  • Medical Device Technology
  • Clinical Diagnostics

Background:

  • Continuous glucose monitoring is crucial for managing critically ill pediatric patients.
  • Flash glucose monitoring (FGM) offers a potential alternative to traditional blood glucose testing.
  • Evaluating FGM performance in pediatric intensive care units (ICUs) is essential.

Purpose of the Study:

  • To assess the accuracy and performance of the FreeStyle Libre flash glucose monitoring system in a pediatric ICU.
  • To compare FGM readings against established glucose measurement methods.

Main Methods:

  • A prospective study involving 16 pediatric ICU patients (age > 4 years).
  • FreeStyle Libre sensors were applied, and measurements were compared to arterial blood gas, capillary blood, and serum analyses.
  • 711 paired measurements were analyzed using mean absolute relative difference (MARD) and surveillance error grid (SEG) analysis.

Main Results:

  • FGM readings were consistently lower than reference methods, with MARD values ranging from 18.99% to 28.34%.
  • Significant linear correlation observed between patient age and MARD.
  • SEG analysis indicated that 92-96% of readings fell within the none or slight risk zones.

Conclusions:

  • The FreeStyle Libre system is well-tolerated in pediatric ICU patients.
  • The system demonstrates a tendency to underestimate glucose levels, indicating suboptimal accuracy for this population.
  • Further validation and potential system improvements are needed for reliable glucose monitoring in critically ill children.

Keywords:
CGMFlashGlucoseIntensive care unitPediatric

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