Continuous glucose monitoring in the ICU: clinical considerations and consensus
Identifieur interne : 000F20 ( Main/Exploration ); précédent : 000F19; suivant : 000F21Continuous glucose monitoring in the ICU: clinical considerations and consensus
Auteurs : James S. Krinsley [États-Unis] ; J. Geoffrey Chase [Nouvelle-Zélande] ; Jan Gunst [Belgique] ; Johan Martensson [Suède] ; Marcus J. Schultz [Pays-Bas, Thaïlande] ; Fabio S. Taccone [Belgique] ; Jan Wernerman [Suède] ; Julien Bohe [France] ; Christophe De Block [Belgique] ; Thomas Desaive [Belgique] ; Pierre Kalfon [France] ; Jean-Charles Preiser [Belgique]Source :
- Critical Care [ 1364-8535 ] ; 2017.
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.
Url:
DOI: 10.1186/s13054-017-1784-0
PubMed: 28756769
PubMed Central: 5535285
Affiliations:
- Belgique, France, Nouvelle-Zélande, Pays-Bas, Suède, Thaïlande, États-Unis
- Centre-Val de Loire, Connecticut, Région Centre, Svealand, Vienne (Autriche)
- Bruxelles, Chartres, Stockholm, Vienne (Autriche)
- Université libre de Bruxelles
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xml:lang="fr">France</country><wicri:regionArea>Lyon</wicri:regionArea></affiliation></author><author><name sortKey="De Block, Christophe" sort="De Block, Christophe" uniqKey="De Block C" first="Christophe" last="De Block">Christophe De Block</name><affiliation wicri:level="1"><nlm:aff id="Aff11"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0626 3418</institution-id><institution-id institution-id-type="GRID">grid.411414.5</institution-id><institution>Department of Endocrinology, Diabetology and Metabolism,</institution><institution>Antwerp University Hospital,</institution></institution-wrap>B-2650 Edegem, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>B-2650 Edegem</wicri:regionArea></affiliation></author><author><name sortKey="Desaive, Thomas" sort="Desaive, Thomas" uniqKey="Desaive T" first="Thomas" last="Desaive">Thomas Desaive</name><affiliation wicri:level="1"><nlm:aff id="Aff12"><institution-wrap><institution-id 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type="city">Chartres</settlement></placeName></affiliation></author><author><name sortKey="Preiser, Jean Charles" sort="Preiser, Jean Charles" uniqKey="Preiser J" first="Jean-Charles" last="Preiser">Jean-Charles Preiser</name><affiliation wicri:level="4"><nlm:aff id="Aff8">Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, 1070 Brussels, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, 1070 Brussels</wicri:regionArea><placeName><region type="land" nuts="2">Vienne (Autriche)</region><settlement type="city">Vienne (Autriche)</settlement><settlement type="city">Bruxelles</settlement></placeName><orgName type="university">Université libre de Bruxelles</orgName></affiliation></author></analytic><series><title level="j">Critical Care</title><idno type="ISSN">1364-8535</idno><idno type="eISSN">1466-609X</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p id="Par1">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.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Van Den Berghe, G" uniqKey="Van Den Berghe G">G van den Berghe</name></author><author><name sortKey="Wouters, P" uniqKey="Wouters P">P Wouters</name></author><author><name sortKey="Weekers, F" uniqKey="Weekers F">F Weekers</name></author><author><name sortKey="Verwaest, C" uniqKey="Verwaest C">C Verwaest</name></author><author><name sortKey="Bruyninckx, F" uniqKey="Bruyninckx F">F Bruyninckx</name></author><author><name sortKey="Schetz, M" uniqKey="Schetz M">M Schetz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Van Den Berghe, G" uniqKey="Van Den Berghe G">G van den Berghe</name></author><author><name sortKey="Wilmer, A" 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Facchinetti</name></author><author><name sortKey="Del Favero, S" uniqKey="Del Favero S">S Del Favero</name></author><author><name sortKey="Sparacino, G" uniqKey="Sparacino G">G Sparacino</name></author><author><name sortKey="Cobelli, C" uniqKey="Cobelli C">C Cobelli</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bochicchio, Gv" uniqKey="Bochicchio G">GV Bochicchio</name></author><author><name sortKey="Hipszer, Br" uniqKey="Hipszer B">BR Hipszer</name></author><author><name sortKey="Magee, Mf" uniqKey="Magee M">MF Magee</name></author><author><name sortKey="Bergenstal, Rm" uniqKey="Bergenstal R">RM Bergenstal</name></author><author><name sortKey="Furnary, Ap" uniqKey="Furnary A">AP Furnary</name></author><author><name sortKey="Gulino, Am" uniqKey="Gulino A">AM Gulino</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Boom, Dt" uniqKey="Boom D">DT Boom</name></author><author><name sortKey="Sechterberger, Mk" uniqKey="Sechterberger M">MK Sechterberger</name></author><author><name sortKey="Rijkenberg, S" uniqKey="Rijkenberg S">S Rijkenberg</name></author><author><name sortKey="Kreder, S" uniqKey="Kreder S">S Kreder</name></author><author><name sortKey="Bosman, Rj" uniqKey="Bosman R">RJ Bosman</name></author><author><name sortKey="Wester, Jp" uniqKey="Wester J">JP Wester</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rooyackers, O" uniqKey="Rooyackers O">O Rooyackers</name></author><author><name sortKey="Blixt, C" uniqKey="Blixt C">C Blixt</name></author><author><name sortKey="Mattsson, P" uniqKey="Mattsson P">P Mattsson</name></author><author><name sortKey="Wernerman, J" uniqKey="Wernerman J">J Wernerman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Krinsley, Js" uniqKey="Krinsley J">JS Krinsley</name></author><author><name sortKey="Bruns, De" uniqKey="Bruns D">DE Bruns</name></author><author><name sortKey="Boyd, Jc" 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Bruxelles</li></orgName></list><tree><country name="États-Unis"><region name="Connecticut"><name sortKey="Krinsley, James S" sort="Krinsley, James S" uniqKey="Krinsley J" first="James S." last="Krinsley">James S. Krinsley</name></region></country><country name="Nouvelle-Zélande"><noRegion><name sortKey="Chase, J Geoffrey" sort="Chase, J Geoffrey" uniqKey="Chase J" first="J. Geoffrey" last="Chase">J. Geoffrey Chase</name></noRegion></country><country name="Belgique"><noRegion><name sortKey="Gunst, Jan" sort="Gunst, Jan" uniqKey="Gunst J" first="Jan" last="Gunst">Jan Gunst</name></noRegion><name sortKey="De Block, Christophe" sort="De Block, Christophe" uniqKey="De Block C" first="Christophe" last="De Block">Christophe De Block</name><name sortKey="Desaive, Thomas" sort="Desaive, Thomas" uniqKey="Desaive T" first="Thomas" last="Desaive">Thomas Desaive</name><name sortKey="Preiser, Jean Charles" sort="Preiser, Jean Charles" uniqKey="Preiser J" first="Jean-Charles" last="Preiser">Jean-Charles Preiser</name><name sortKey="Taccone, Fabio S" sort="Taccone, Fabio S" uniqKey="Taccone F" first="Fabio S." last="Taccone">Fabio S. Taccone</name></country><country name="Suède"><noRegion><name sortKey="Martensson, Johan" sort="Martensson, Johan" uniqKey="Martensson J" first="Johan" last="Martensson">Johan Martensson</name></noRegion><name sortKey="Wernerman, Jan" sort="Wernerman, Jan" uniqKey="Wernerman J" first="Jan" last="Wernerman">Jan Wernerman</name></country><country name="Pays-Bas"><noRegion><name sortKey="Schultz, Marcus J" sort="Schultz, Marcus J" uniqKey="Schultz M" first="Marcus J." last="Schultz">Marcus J. Schultz</name></noRegion></country><country name="Thaïlande"><noRegion><name sortKey="Schultz, Marcus J" sort="Schultz, Marcus J" uniqKey="Schultz M" first="Marcus J." last="Schultz">Marcus J. Schultz</name></noRegion></country><country name="France"><noRegion><name sortKey="Bohe, Julien" sort="Bohe, Julien" uniqKey="Bohe J" first="Julien" last="Bohe">Julien Bohe</name></noRegion><name sortKey="Kalfon, Pierre" sort="Kalfon, Pierre" uniqKey="Kalfon P" first="Pierre" last="Kalfon">Pierre Kalfon</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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