The use of continuous glucose monitoring: A scoping review of accuracy, feasibility and nursing workload reduction in intensive care setting

Background

Hyperglycemia is prevalent in intensive care units (ICUs), associated with increased mortality. Management involves frequent point-of-care glucose (POC-G), but continuous glucose monitoring (CGM) shows promise in improving glycemic control.

Aims

To explore the knowledge in the literature about the impact and accuracy of CGM in ICUs.

Design

A scoping review was conducted; PubMed, Web of Science, CINAHL, Scopus databases and Gray Literature covering the period from September 2018 to September 2024.

Methods

Data abstraction, quality appraisal, and narrative synthesis were carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines.

Results

Of the 952 titles reviewed, 20 articles were included. Clinical outcomes were mean absolute relative difference (MARD), ranged from 9.3% to 20.6%. Additionally, there was a 30–71% reduction of POC-G measurements. Time in range (TIR) varied from 46.1% to 100%. Clarke Error Grid (CEG) analysis demonstrated that over 98% of the glucose values fell within zones A and B.

Conclusions

CGM in the ICU reduces nursing workload, enhances patient safety, and facilitates early intervention for abnormal glucose levels, demonstrating its feasibility, accuracy and effectiveness in critical care settings. Additional clinical trials are needed to validate these findings and establish optimal usage parameters.

Relevance to clinical practice

CGM came to stay in ICU. Therefore, it is crucial to start training critical care nurses in the use of CGM. This will enable us to maximize their benefits in terms of reducing nursing workload and enhancing patient safety.