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Sensors 2017, 17(1), 146; doi:10.3390/s17010146

The Clinical Benefits and Accuracy of Continuous Glucose Monitoring Systems in Critically Ill Patients—A Systematic Scoping Review

1
Clinical Diabetology, Academic Medical Center, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
2
Department of Intensive Care Medicine, Onze Lieve Vrouwe Gasthuis, P.O. Box 95500, 1090 HM Amsterdam, The Netherlands
3
Medical Library, Academic Medical Center, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
4
Department of Anesthesiology, Academic Medical Center, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
*
Author to whom correspondence should be addressed.
Academic Editor: W. Rudolf Seitz
Received: 28 September 2016 / Revised: 15 December 2016 / Accepted: 8 January 2017 / Published: 14 January 2017
(This article belongs to the Special Issue Glucose Sensors: Revolution in Diabetes Management 2016)
View Full-Text   |   Download PDF [411 KB, uploaded 16 January 2017]   |  

Abstract

Continuous Glucose Monitoring (CGM) systems could improve glycemic control in critically ill patients. We aimed to identify the evidence on the clinical benefits and accuracy of CGM systems in these patients. For this, we performed a systematic search in Ovid MEDLINE, from inception to 26 July 2016. Outcomes were efficacy, accuracy, safety, workload and costs. Our search retrieved 356 articles, of which 37 were included. Randomized controlled trials on efficacy were scarce (n = 5) and show methodological limitations. CGM with automated insulin infusion improved time in target and mean glucose in one trial and two trials showed a decrease in hypoglycemic episodes and time in hypoglycemia. Thirty-two articles assessed accuracy, which was overall moderate to good, the latter mainly with intravascular devices. Accuracy in critically ill children seemed lower than in adults. Adverse events were rare. One study investigated the effect on workload and cost, and showed a significant reduction in both. In conclusion, studies on the efficacy and accuracy were heterogeneous and difficult to compare. There was no consistent clinical benefit in the small number of studies available. Overall accuracy was moderate to good with some intravascular devices. CGM systems seemed however safe, and might positively affect workload and costs. View Full-Text
Keywords: (blood) glucose; continuous glucose monitoring (CGM); glucose sensors; biosensing techniques; intensive care (unit); critical illness; accuracy (blood) glucose; continuous glucose monitoring (CGM); glucose sensors; biosensing techniques; intensive care (unit); critical illness; accuracy
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

van Steen, S.C.J.; Rijkenberg, S.; Limpens, J.; van der Voort, P.H.J.; Hermanides, J.; DeVries, J.H. The Clinical Benefits and Accuracy of Continuous Glucose Monitoring Systems in Critically Ill Patients—A Systematic Scoping Review. Sensors 2017, 17, 146.

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