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Continuous Glucose Monitoring Using the Dexcom G6 in Cardiac Surgery During the Postoperative Period.

Steven R Insler¹, Brett Wakefield¹, Andrea Debs²

¹Departments of Intensive Care and Resuscitation and Cardiothoracic Anesthesiology, The Cleveland Clinic Foundation, Cleveland, Ohio.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists

|May 1, 2024

Summary

This pilot study assessed the accuracy of the Dexcom G6Pro continuous glucose monitor (CGM) in postsurgical cardiac patients. While most readings were clinically acceptable, the device

Keywords:

Arterial Blood Gas Cardiopulmonary Bypass Cardiovascular Intensive Care Unit Continuous Glucose monitor Glucose Hyperglycemia

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Area of Science:

Cardiology
Endocrinology
Medical Device Technology

Background:

Cardiac surgery frequently causes hyperglycemia, linked to poor patient outcomes like infections and mortality.
Effective glucose monitoring is crucial for managing postsurgical hyperglycemia and improving patient recovery.

Purpose of the Study:

To evaluate the accuracy of the Dexcom G6Pro continuous glucose monitor (CGM) compared to standard methods in the immediate postoperative period after cardiac surgery.
To assess CGM performance amidst common postsurgical complications such as fluid shifts and inflammatory responses.

Main Methods:

A prospective study involving 29 patients undergoing cardiac surgery.
Correlation analysis between 1428 clinical glucose readings and 45,645 Dexcom G6Pro CGM data points.
Data analysis included Clarke and consensus error grids, with subsets excluding the initial 24 hours post-ICU admission.

Main Results:

Over 99% of Dexcom G6Pro CGM readings fell into clinically acceptable zones (A and B) on error grids.
Mean absolute relative difference between CGM and clinical measurements was approximately 20-22%.
No adverse events were reported during the study period.

Conclusions:

The Dexcom G6Pro CGM demonstrated a high rate of clinically acceptable glucose readings in postsurgical cardiac patients.
Despite acceptable clinical decision-making, the mean absolute relative difference limits its current use for direct treatment decisions.
Continuous glucose monitoring holds future potential for managing glycemic fluctuations and improving patient outcomes in critical care settings.