Proposed Topic (Most preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Proposed Topic (Second preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for 10 years or less)
Authors (including presenting author) :
He Z(1), Yeung MW(1), Lo WPJ(1), Shum HP(1)
Affiliation :
(1) Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital
Introduction :
Continuous glucose monitoring (CGM) is increasingly used in diabetic patients to improve and maintain good glycemic control. Dysglycaemia, i.e., both hypoglycemia and hyperglycemia, are commonly observed in septic patients, even in non-diabetic subjects. Patients with septic shock under critical care may benefit from CGM. However, limited data is available on the performance of CGM on this group of patients.
Objectives :
To evaluate the correlation between interstitial glucose measured by Dexcom continuous glucose monitoring (CGM) and blood glucose measured by Statstrip glucometer (POCBG) in critically ill patients on vasopressors.
Methodology :
This retrospective study included patients admitted to PYNEH ICU from Jul –Dec 2023 for septic shock with vasopressor usage for hemodynamic support. A CGM machine (seventh generation (G7) Dexcom CGM) was applied to the upper arm of recruited patients with blood glucose values provided every 5 minutes. Arterial blood was sampled for blood glucose measurement by an intelligent-point-of-care testing machine (StatStrip Glucose/Ketone Meters) (POCBG) at a frequency based on physician discretion. CGM blood glucose values were retrieved for comparison. Correlation between the CGM and POCBG measurement was assessed by the Pearson correlation coefficient. The agreement between the two measurements was assessed by the Bland-Altman Plot.
Result & Outcome :
The study included 6 critically ill patients, from whom 91 valid pairs of data were obtained. The dosage of vasopressor usage ranged from 0.05-1.8µg/kg/min. The CGM showed high correlation with POCBG with Pearson correlation coefficient 0.759. CGM has consistently higher measurement than POCBG monitoring (p < 0.001). From the Bland Altman plot, the mean difference between POCBG and CGM is -2.4mmol/L. 92.3% of points are found within 2 Standard deviation from mean value.
In conclusion, CGM showed good correlation with POCBG but only moderate reliability in patients with septic shock.
