Continuous glucose monitoring in ICU

Control of blood glucose (BG) to a normal range in critical care has shown distinct benefits, but has also proven difficult to obtain. The risk of severe hypoglycaemia (blood glucose < 2.2mmol/L) raises significant concerns for patient safety. Accurate BG measurements are essential for control protocols to work safely and effectively. This study will be completed in two parts: 1 – The current method of measuring BG levels (glucometer) will be assessed/validated in critically ill patients. Glucometer measurements will be compared to paired gold standard BG measurements, determined by the blood gas machine. The goal is to improve care through more accurate bedside BG measurement methods. 2 – Continuous Glucose Monitors (CGMs) offer an automated 5 minute measurement rate with the trade off of reduced accuracy. Compared to glucometers, these devices are capable of capturing glycaemic trends that would normally go unnoticed when measuring 1-4 hourly. CGMs will be used as an observational tool in critically ill patients in this study. Each patients will have 3 CGMs attached concurrently (two in the abdomen, one in the thigh), allowing variability of the device to be assessed. Analysis of the CGM data will help our understanding of the CGM error characteristics. If variability is managed effectively, these devices offer the potential to improve BG control while reducing nursing workload.