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Title: Continuous glucose monitoring in the ICU: clinical considerations and consensus.
Austin Authors: Krinsley, James S;Chase, J Geoffrey;Gunst, Jan;Martensson, Johan;Schultz, Marcus J;Taccone, Fabio S;Wernerman, Jan;Bohe, Julien;De Block, Christophe;Desaive, Thomas;Kalfon, Pierre;Preiser, Jean-Charles
Affiliation: Division of Critical Care, Department of Medicine, Stamford Hospital, Columbia University College of Physicians and Surgeons, Stamford, CT, 06902, USA
Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
Department of Anesthesia and Intensive Care Medicine, Karolinska University Hospital, Department of Physiology and Pharmacology, Karolinska Institutet, 171 77, Stockholm, Sweden
Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
Department of Intensive Care, Laboratory of Experimental Intensive Care and Anesthesia (L E I C A), Faculty of Tropical Medicine, Mahidol University, Mahidol-Oxford Research Unit (MORU), Bangkok, Thailand
Department of Mechanical Engineering, Centre for Bio-Engineering, University of Canterbury, Christchurch, 8140, New Zealand
Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, 3000, Leuven, Belgium
Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, 1070, Brussels, Belgium
Karolinska University Hospital Huddinge & Karolinska Institutet, K32 14186, Stockholm, Sweden
Medical Intensive Care Unit, University Hospital of Lyon, Lyon, France
Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, B-2650, Edegem, Belgium
GIGA-In Silico Medicine, Université de Liège, B4000, Liège, Belgium
Service de Réanimation polyvalente, Hôpital Louis Pasteur, CH de Chartres, 28000, Chartres, France
Issue Date: 31-Jul-2017
Date: 2017-07-31
Publication information: Critical Care 2017; 21(1): 197
Abstract: 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.
DOI: 10.1186/s13054-017-1784-0
ORCID: 0000-0001-8739-7896
Journal: Critical Care
PubMed URL: 28756769
Type: Journal Article
Subjects: Diabetes
Neurointensive care
Appears in Collections:Journal articles

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