Christian Gantzel Nielsen, Milda Grigonyte-Daraskeviciene, Mathias Maagaard Blem, Peter Lommer Kristensen, Ulrik Pedersen-Bjergaard, Mikkel Thor Olsen, Kirsten Nørgaard, Anders Perner, Johan Mårtensson, Morten Hylander Møller, Morten Heiberg Bestle
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引用次数: 0
Abstract
Background: Glucose management in intensive care unit (ICU) patients is challenging, and dysglycemia is associated with increased morbidity and mortality. Continuous glucose monitoring (CGM) could be a potential tool to improve clinical and glycemic outcomes compared with current practice which relies on intermittent glucose measurements.
Aim: The aim of this systematic review and meta-analysis is to assess the effects of CGM compared with point of care (POC) glucose measurements on clinical patient-important and glycemic outcomes in ICU patients.
Methods: This protocol is based on the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guideline. We will include all randomized clinical trials in ICU patients. The primary outcome is mortality at the longest follow-up, and the main-secondary outcome is the number of hypoglycemic events. Additional outcomes include both patient-important and glycemic outcomes. We will systematically search: PubMed, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and Web of Science Core Collection. We will assess risk of bias using the Cochrane Risk of Bias 2 tool and conduct a Trial Sequential Analysis for the primary and main-secondary outcome. Clinical heterogeneity will be assessed using the Clinical Diversity in meta-analyses tool, and the certainty of evidence will be assessed using the Grading of Recommendation Assessment, Development, and Evaluation approach.
Discussion: This systematic review with meta-analysis will provide an updated overview and synthesis of the effect of CGM versus POC glucose monitoring to inform clinical practice and future trials.
背景:重症监护病房(ICU)患者的血糖管理具有挑战性,血糖异常与发病率和死亡率增加有关。与目前依赖间歇性血糖测量的做法相比,连续血糖监测(CGM)可能是改善临床和血糖结果的潜在工具。目的:本系统综述和荟萃分析的目的是评估CGM与护理点(POC)血糖测量对ICU患者临床患者重要结局和血糖结局的影响。方法:该方案基于系统评价和荟萃分析方案的首选报告项目指南。我们将纳入ICU患者的所有随机临床试验。主要结局是最长随访时的死亡率,次要结局是低血糖事件的次数。其他结局包括患者重要结局和血糖结局。我们将系统地检索:PubMed, Embase, Cochrane中央对照试验登记,护理和联合健康文献累积索引,以及Web of Science核心集合。我们将使用Cochrane risk of bias 2工具评估偏倚风险,并对主要和主要次要结局进行试验序列分析。临床异质性将使用临床多样性荟萃分析工具进行评估,证据的确定性将使用分级推荐评估、发展和评估方法进行评估。讨论:本系统综述与荟萃分析将提供CGM与POC血糖监测效果的最新概述和综合,为临床实践和未来的试验提供信息。
期刊介绍:
Acta Anaesthesiologica Scandinavica publishes papers on original work in the fields of anaesthesiology, intensive care, pain, emergency medicine, and subjects related to their basic sciences, on condition that they are contributed exclusively to this Journal. Case reports and short communications may be considered for publication if of particular interest; also letters to the Editor, especially if related to already published material. The editorial board is free to discuss the publication of reviews on current topics, the choice of which, however, is the prerogative of the board. Every effort will be made by the Editors and selected experts to expedite a critical review of manuscripts in order to ensure rapid publication of papers of a high scientific standard.