Autori: Mona-Britt Divander
Ustanova zaposlenja: SWEDEN
Ključne riječi: TGC, CGM, Variability, Hypoglycemia, Venous
Kongres/Simpozij: ”5. Međunarodni kongres HDMSARIST-a” i ”8. Međunarodni kongres WFCCN-a”
Mjesto i vrijeme održavanja: Šibenik, 12.-15. travnja 2012. godine
Introduction:
Tight glucose control has been put aside in many critical care settings. It has
been suggested that future interventional trials should not be performed
without the means to control and measure glycaemia in three areas central
tendency, variability and minimum value. A recent innovation in central venous
catheters which allow continuous glucose sampling may allow critical care
nurses to easily gather information in these three domains.
Methods: Two patients undergoing planned general surgery procedure with were
monitored using a 7Fr triple lumen central venous catheter (Eirus TLC, Dipylon
Medical AB, Solna, Sweden) with an integrated microdialysis membrane located
proximal to all infusion ports. The catheter was percutaneously placed and
connected to the Eirus monitoring system. Equilibrium of glucose is achieved
across the membrane and glucose concentration is measured by the sensor and
displayed on the monitor. The system was calibrated after 1 hour and then every
8 hours, using arterial blood gas as the reference. The patients were monitored
for 19 hours in the post anesthesia care unit.
Results: The Eirus system allows one to download minute glucose data. Central
tendency was measured by average glucose; Variability as measured by Standard
deviation. For Patient 1: Total up-time: 19 h 51 min (1191 min); Average: 7.80
mmol/L; Stdev: 0.76 mmol/L; and Min: 6.29 mmol/L. For Patient 2: Total up-time:
18 h 52 min (1132 min); Average: 9.75 mmol/L; Stdev: 3.89 mmol/L and Min: 4.02
mmol/L.
Conclusions: Central venous microdialysis is an innovative technology that is
managed by the critical nurses responsible for glucose control protocols. It
provides relevant CGM data in all important domains. With such a tool it may be
possible to re-investigate and perhaps carry out TGC protocols.