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Published on: February 24, 2023
Intraoperative Continuous Glucose Monitor Sensor-Receiver Connectivity Is Maintained With Alternative Sensor
Reece Stutzman1, Lauren S Pineda1, Edgardo E Reynoso1
1Department of Anesthesiology, Loma Linda University Medical Center, Loma Linda, California, USA.
Introduction:
Perioperative glycaemic control is associated with reduced postoperative complications. However, regulatory restrictions on point-of-care device operation and operative positioning constraints, reducing accessibility for dermal puncture, may hinder intraoperative monitoring. Although continuous glucose monitors (CGM) support real-time glucose monitoring, intraoperative patient positioning may increase compression low susceptibility, and electrosurgery interference may affect sensor-receiver connectivity. Alternative CGM sensor placement may improve intraoperative sensor-receiver connectivity.
Methods:
In this prospective pilot study of adult surgical patients, CGM sensors were inserted in the lateral upper arm (deltoid) or lateral thigh (thigh) to limit patient position-related sensor pressure. The primary endpoint evaluated proportional duration of CGM sensor-receiver connectivity during surgery. Comparison of sensor-receiver connectivity by placement site, relation to electrosurgery and the number of alerts from the CGM receiver were also reported.
Results:
Forty-five subjects were randomized: 22 deltoid and 23 thigh CGM placement. Four subjects were excluded; 20 deltoid and 21 thigh CGM sensor placements were analysed. Sensor-receiver connectivity was maintained during the surgical procedure in 40 (97.6%) irrespective of electrosurgery (21 thigh, 19 deltoid; difference 0, 95% CI: 0-0; p = 0.329). Of 26 receiver alerts, 11 occurred during electrosurgery; 15 were unrelated to electrosurgery. There was no difference in receiver alerts between deltoid and thigh placement (chi square p = 0.17; difference 0.18; 95% CI: -0.07 to 0.42).
Conclusion:
Finding consistent sensor-receiver connectivity using alternative CGM sensor placement sites supports intraoperative CGM feasibility. If future studies demonstrate alternative CGM sensor placement sites retain accuracy, then broader intraoperative CGM application may be reasonable.
Trial Registration:
NCT06614127 | https://clinicaltrials.gov/study/NCT06614127.
