Continuous glucose monitoring in the ICU: Clinical considerations and consensus

[en] 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. © 2017 The Author(s).

Disciplines :

Anesthesia & intensive care

Author, co-author :

Krinsley, J. S.; Stamford Hospital, Columbia University College of Physicians and Surgeons, Division of Critical Care, Department of Medicine, Stamford, CT, United States

Chase, J. G.; University of Canterbury, Department of Mechanical Engineering, Centre for Bio-Engineering, Christchurch, New Zealand

Gunst, J.; KU Leuven, Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, Leuven, Belgium

Martensson, J.; Austin Hospital, Department of Intensive Care, Heidelberg, VIC, Australia, Department of Anesthesia and Intensive Care Medicine, Karolinska University Hospital, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden

Schultz, M. J.; Academic Medical Center, Meibergdreef 9, Amsterdam, Netherlands, Faculty of Tropical Medicine, Mahidol University, Mahidol-Oxford Research Unit (MORU), Department of Intensive Care, Laboratory of Experimental Intensive Care and Anesthesia (L E I C A), Bangkok, Thailand

Taccone, F. S.; Erasme Hospital, Université libre de Bruxelles, Department of Intensive Care, Brussels, Belgium

Wernerman, J.; Karolinska University Hospital Huddinge and Karolinska Institutet, K32 14186, Stockholm, Sweden

Bohe, J.; University Hospital of Lyon, Medical Intensive Care Unit, Lyon, France

De Block, C.; Antwerp University Hospital, Department of Endocrinology, Diabetology and Metabolism, Edegem, Belgium

Desaive, Thomas ; Université de Liège - ULiège > Département d'astrophys., géophysique et océanographie (AGO) > Thermodynamique des phénomènes irréversibles

Kalfon, P.; Hôpital Louis Pasteur, CH de Chartres, Service de Réanimation polyvalente, Chartres, France

Preiser, J.-C.; Erasme Hospital, Université libre de Bruxelles, Department of Intensive Care, Brussels, Belgium

Language :

English

Title :

Continuous glucose monitoring in the ICU: Clinical considerations and consensus

Publication date :

2017

Journal title :

Critical Care

ISSN :

1364-8535

eISSN :

1466-609X

Publisher :

BioMed Central Ltd.

Volume :

Issue :

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 16 April 2018

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