Continuous glucose monitoring in the ICU: clinical considerations and consensus

Critical Care

卷:21

Marcus J. Schultz¹  Jan Gunst²  Christophe De Block³  Johan Martensson⁴  Fabio S. Taccone⁵  Jean-Charles Preiser⁵  J. Geoffrey Chase⁶  James S. Krinsley⁷  Thomas Desaive⁸  Jan Wernerman⁹  Julien Bohe¹⁰  Pierre Kalfon¹¹ 

[1] Academic Medical Center;

[2] Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven;

[3] Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital;

[4] Department of Intensive Care, Austin Hospital;

[5] Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles;

[6] Department of Mechanical Engineering, Centre for Bio-Engineering, University of Canterbury;

[7] Division of Critical Care, Department of Medicine, Stamford Hospital, Columbia University College of Physicians and Surgeons;

[8] GIGA—In Silico Medicine, Université de Liège;

[9] Karolinska University Hospital Huddinge & Karolinska Institutet;

[10] Medical Intensive Care Unit, University Hospital of Lyon;

[11] Service de Réanimation polyvalente, Hôpital Louis Pasteur, CH de Chartres;

关键词: Glucose;    Insulin;    Diabetes;    Neurointensive care;    Monitoring;   

DOI  :  10.1186/s13054-017-1784-0

来源: DOAJ

【 摘 要 】

Abstract Glucose management in intensive care unit (ICU) patients has been a matter of debate for almost two decades. Compared to intermittent monitoring systems, continuous glucose monitoring (CGM) can offer benefit in the prevention of severe hyperglycemia and hypoglycemia by enabling insulin infusions to be adjusted more rapidly and potentially more accurately because trends in glucose concentrations can be more readily identified. Increasingly, it is apparent that a single glucose target/range may not be optimal for all patients at all times and, as with many other aspects of critical care patient management, a personalized approach to glucose control may be more appropriate. Here we consider some of the evidence supporting different glucose targets in various groups of patients, focusing on those with and without diabetes and neurological ICU patients. We also discuss some of the reasons why, despite evidence of benefit, CGM devices are still not widely employed in the ICU and propose areas of research needed to help move CGM from the research arena to routine clinical use.

【 授权许可】

Unknown