Anest. intenziv. Med. 2009;20(3):153-157

Blood and tissue glucose level in critically ill patients: Comparison of different methods of measuring interstitial glucose levelsIntensive Care Medicine - Original Paper

Stoszková Andrea^1,*, Dostál Pavel¹, Musil František², Šmahelová Alena², Zadák Zdeněk³, Černý Vladimír¹

¹ Klinika anesteziologie, resuscitace a intenzivní medicíny Fakultní nemocnice Hradec Králové

² Klinika gerontologická a metabolická, Fakultní nemocnice Hradec Králové

³ Centrum pro vývoj a výzkum LF UK a Fakultní nemocnice Hradec Králové

Objective:
The aim of study is to investigate whether the glucose values obtained by miniinvasive techniques of interstitial glucose monitoring (Guardian Real Time (RT) continuous glucose monitoring system and microdialysis) differ substantially from blood glucose readings and whether these methods could be used instead of blood glucose sampling in mechanically ventilated patients with tight glycemic control.

Design:
Local, prospective study.
Setting:
Department of Anesthesiology and Intensive Care, University Hospital.

Materials and methods:
Interstitial glucose concentrations were measured by the Guardian RT system and by the microdialysis of subcutaneous adipose tissue. The microdialysis catheter was constantly perfused with isotonic solution at a flow rate of 0.3 µL/min. Dialysate was collected in hourly fractions. Arterial and venous blood samples were collected in hourly intervals during 24 hours and paired with Guardian RT and microdialysis readings. Data were analyzed using the Bland-Altman method and the correlation coefficient was calculated.

Results:
Correlation coefficient between arterial glycemia and microdialysis interstitial glucose level was r = 0.7044 (P < 0.0001). Correlation coefficient between arterial glycemia and Guardian RT readings was r = 0.6938 (P < 0.0001). Correlation between interstitial glucose level obtained by microdialysis and Guardian RT glucose readings was r = 0.5736 (P < 0.0001).

Conclusion:
Due to obtained results, microdialysis and Guardian Real Time continuous glucose monitoring system could not be considered equivalent to blood glucose measurement and findings do not support their use for tight glycemic control management in mechanically ventilated, critically ill patients.

Keywords: tight glycemic control; interstitial glucose; microdialysis; Guardian Real Time Continuous Glucose Monitoring System

Received: November 24, 2008; Accepted: March 10, 2009; Published: June 1, 2009  Show citation