Using Dexcom G7 in Critically Ill Infant With Hyperinsulinemia on High Frequency Oscillatory Ventilation Support.

Abstract

Introduction: Life threatening hypoglycemia can occur during critical illness in infants with underlying hyperinsulinemia or metabolic conditions, such as glycogen storage diseases. Using a continuous glucose monitor (CGM) can provide insight into glycemic trends with this high-risk patient population in the intensive care setting. Barriers to usage of CGMs in the intensive care unit include familiarity with CGMs devices among staff, safety, and cost.

Case presentation: We describe the first reported case of safely utilizing the newest Dexcom G7 continuous glucose monitor in an infant with hyperinsulinemia undergoing high frequency oscillatory ventilator (HFOV) support for acute respiratory distress syndrome (ARDS) to detect early hypoglycemic episodes during critical illness while on continuous glucose infusion.

Conclusion: There is limited information on using the Dexcom G7 CGM device in infants with underlying hypoglycemic conditions on HFOV support. The use of HFOV poses a unique physiological challenge for using a CGM device. We demonstrate that the Dexcom G7 is safe to use while on HFOV. The device provided important glycemic trends, which helped to reduce the number of point-of-care tests and allowed for early detection of hypoglycemia.