Flash Glucose Monitoring for Predicting Cardiogenic Shock Occurrence in Critically Ill Patients: A Retrospective Pilot Study.

IF 3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Velimir Altabas, Dorijan Babić, Anja Grulović, Tomislav Bulum, Zdravko Babić
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Abstract

Background/Objectives: Continuous and flash glucose monitoring (CGM and FGM) may enhance glucose management by providing real-time glucose data. Furthermore, growing evidence is linking altered blood glucose concentrations and worse short-term outcomes in critically ill patients. While hyperglycemia is more common in these patients and is associated with an increased risk of adverse events, hypoglycemia is particularly concerning and significantly raises the risk of fatal outcomes. This exploratory study investigated the link between FGM variables and cardiogenic shock in critically ill Coronary Care Unit (CCU) patients. Methods: Twenty-eight CCU patients (1 May 2021-31 January 2022) were monitored using a Libre FreeStyle system. Analyzed data included patient demographic and laboratory data, left ventricular ejection fraction, standard glucose monitoring, APACHE IV scores, and cardiogenic shock occurrence. Analysis was performed using the χ2 test, Mann-Whitney U test, and logistic regression. Results: Among the patients, 13 (46.43%) developed cardiogenic shock. FGM detected hypoglycemia in 18 (64.29%) patients, while standard methods in 6 (21.43%) patients. FGM-detected hypoglycemia was more frequent in patients who developed cardiogenic shock (p = 0.0129, χ2 test) with a significantly higher time below range reading (p = 0.0093, Mann Withney U test), despite no differences in mean glucose values. In addition, hypoglycemia detected by FGM was an independent predictor of shock (p = 0.0390, logistic regression). Conclusions: FGM identified more hypoglycemic events compared to standard glucose monitoring in the CCU. Frequent FGM-detected hypoglycemic events were associated with cardiogenic shock, regardless of a history of diabetes. Due to a limited sample size, these results should be interpreted cautiously and further research in this area is justified.

快速血糖监测预测危重患者心源性休克的发生:一项回顾性试点研究。
背景/目的:连续和瞬时血糖监测(CGM和FGM)可以通过提供实时血糖数据来加强血糖管理。此外,越来越多的证据表明,危重患者的血糖浓度变化与更糟糕的短期预后有关。虽然高血糖在这些患者中更为常见,并与不良事件的风险增加有关,但低血糖尤其令人担忧,并显著增加了致命结果的风险。本探索性研究探讨了女性生殖器切割变量与危重重症冠心病患者心源性休克之间的联系。方法:28例CCU患者(2021年5月1日至2022年1月31日)使用Libre FreeStyle系统进行监测。分析的数据包括患者人口统计学和实验室数据、左心室射血分数、标准血糖监测、APACHE IV评分和心源性休克的发生。采用χ2检验、Mann-Whitney U检验和logistic回归进行分析。结果:13例(46.43%)发生心源性休克。女性生殖器切割检出低血糖者18例(64.29%),而标准方法检出低血糖者6例(21.43%)。在发生心源性休克的患者中,fgm检测到的低血糖更常见(p = 0.0129, χ2检验),低于读数范围的时间也更长(p = 0.0093, Mann Withney U检验),尽管平均血糖值没有差异。此外,FGM检测到的低血糖是休克的独立预测因子(p = 0.0390, logistic回归)。结论:与CCU的标准血糖监测相比,FGM识别出更多的低血糖事件。不论是否有糖尿病史,女性生殖器切割检测到的频繁低血糖事件与心源性休克有关。由于样本量有限,这些结果应谨慎解释,并在该领域进一步研究是合理的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Diagnostics
Diagnostics Biochemistry, Genetics and Molecular Biology-Clinical Biochemistry
CiteScore
4.70
自引率
8.30%
发文量
2699
审稿时长
19.64 days
期刊介绍: Diagnostics (ISSN 2075-4418) is an international scholarly open access journal on medical diagnostics. It publishes original research articles, reviews, communications and short notes on the research and development of medical diagnostics. There is no restriction on the length of the papers. Our aim is to encourage scientists to publish their experimental and theoretical research in as much detail as possible. Full experimental and/or methodological details must be provided for research articles.
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