Evidence map›Paper›PMID 31744315›Full record

ArticleJournal of diabetes science and technology2021

Fifteen-minute Frequency of Glucose Measurements and the Use of Threshold Alarms: Impact on Mitigating Dysglycemia in Critically Ill Patients.

Grant V Bochicchio, Stanley A Nasraway, Laura J Moore, Anthony P Furnary, Eden A Nohra, Kelly M Bochicchio, James C Boyd, David I Bruns, Irl B Hirsch, Jean-Charles Preiser and 1 more

Open access · bronzeAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of diabetes science and technology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.8field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 8 institutions in 2 countries.

Grant V BochicchioWashington University, St. Louis School of Medicine, MO, USA.
Stanley A NasrawayTufts University School of Medicine, Boston, MA, USA.
Laura J MooreDepartment of Surgery, University of Texas, McGovern Medical School, Houston, TX, USA.
Anthony P FurnaryProvidence St Vincent Medical Center, Portland, OR, USA.
Eden A NohraWashington University, St. Louis School of Medicine, MO, USA.
Kelly M BochicchioWashington University, St. Louis School of Medicine, MO, USA.
James C BoydUniversity of Virginia Health System, Charlottesville, VA, USA.
David I BrunsUniversity of Virginia Health System, Charlottesville, VA, USA.
Irl B HirschUniversity of Washington School of Medicine, Seattle, WA, USA.
Jean-Charles PreiserErasme University Hospital, Brussels, Belgium.
James S KrinsleyDivision of Critical Care, Stamford Hospital and Columbia Vagelos College of Physicians and Surgeons, CT, USA.ORCID 0000-0002-3763-5857
Washington University in St. Louis · USUniversity of Virginia Health System · USErasmus Hospital · BEMemorial Hermann · USProvidence St. Vincent Medical Center · USStamford Hospital · USTufts University · USUniversity of Washington · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe use of near-continuous blood glucose (BG) monitoring has the potential to improve glycemic control in critically ill patients. The MANAGE IDE trial evaluated the performance of the OptiScanner (OS) 5000 in a multicenter cohort of 200 critically ill patients.

methodsAn Independent Group reviewed the BG run charts of all 200 patients and voted whether unblinded use of the OS, with alarms set at 90 and 130 to 150 mg/dL to alert the clinical team to impending hypoglycemia and hyperglycemia, respectively, would have eliminated episodes of dysglycemia: hypoglycemia, defined as a single BG <70 mg/dL; hyperglycemia, defined as >4 hours of BG >150 mg/dL; severe hyperglycemia, defined as >4 hours of BG >200 mg/dL and increased glucose variability (GV), defined as coefficient of variation (CV) >20%.

resultsAt least one episode of dysglycemia occurred in 103 (51.5%) of the patients, including 6 (3.0%) with hypoglycemia, 83 (41.5%) with hyperglycemia, 18 (9.0%) with severe hyperglycemia, and 40 (20.0%) with increased GV. Unblinded use of the OS with appropriate alarms would likely have averted 97.1% of the episodes of dysglycemia: hypoglycemia (100.0%), hyperglycemia (96.4%), severe hyperglycemia (100.0%), and increased GV (97.5%). Point accuracy of the OS was very similar to that of the point of care BG monitoring devices used in the trial.

conclusionUnblinded use of the OS would have eliminated nearly every episode of dysglycemia in this cohort of critically ill patients, thereby markedly improving the quality and safety of glucose control.

Indexed as

HyperglycemiaHypoglycemiaBlood GlucoseCritical IllnessHumansRetrospective StudiesBlood Glucosecontinuous glucose monitoringcritically illglucose controlglucose variabilityhyperglycemiahypoglycemia

Identifiers

PMID31744315
PMCPMC8256060
OpenAlexW2990532001

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.