The effects of continuous glucose monitoring used in septic shock patients with different tissue perfusion
10.3969/j.issn.1008-9691.2017.03.014
- VernacularTitle:不同组织灌注水平感染性休克患者的动态血糖监测效果
- Author:
Yifeng GUO
;
Yun LONG
;
Dawei LIU
;
Hong SUN
;
Hailing GUO
;
Zunzhu LI
;
Yufen MA
;
Wei HAN
;
Aimin GUO
- Keywords:
Septic shock;
Interstitial fluid glucose;
Arterial blood glucose;
Tissue perfusion;
Consistency;
Continuous glucose monitoring
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2017;24(3):278-282
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the consistency between interstitial fluid glucose and arterial blood glucose in septic shock patients with different tissue perfusion levels.Methods A prospective investigative study was conducted. Sixty-one septic shock patients with ages above 18 years old admitted to the Department of Critical Care Medicine of Peking Union Medical College Hospital, Chinese Academy of Medical Sciences from April 2013 to December 2013 were enrolled. The real-time continuous glucose monitoring system (RTCGMS) and arterial blood gas analyzer were used to measure the patients' interstitial fluid glucose and arterial blood glucose, and according to the criteria of International Organization for Standardization (ISO) and the median of relative absolute difference (Median RAD), the consistency between interstitial fluid glucose and arterial blood glucose was calculated. Based on the lactate (Lac) level and pulse oxygen perfusion index (PI), the septic shock patients were divided into groups with different degrees of tissue perfusion, the consistency between the interstitial fluid glucose and arterial blood glucose among septic shock patients with different degrees of tissue perfusion was compared by using Bootstrap re-sampling technique.Results Negative correlation existed between PI and Lac (r= -0.272,P < 0.001), which showed the opposite change tendency of organism tissue perfusion. In patients with Lac > 8 mmol/L, their consistency between interstitial fluid glucose and arterial blood glucose was better than that in those with Lac > 2-4 mmol/L, and the 95% credibility intervals (CI) of ISO standardized deviation value was 0.026-38.710 (P < 0.05). In patients with PI ≤ 0.7%, their consistency between interstitial fluid glucose and arterial blood glucose was better than that in those with PI > 0.7%-1.4%, the 95%CI of median RAD difference value was 0.002-0.076, and the 95%CI of ISO standardized deviation value was -27.000 to -0.583 (allP < 0.05); in patients with PI > 3.0%, their consistency between interstitial fluid glucose and arterial glucose was better than that in those with PI ≤ 0.7%, PI > 0.7%-1.4% and PI > 1.4%-3.0%, and the 95%CI of ISO standardized deviation values were 3.322-28.302, 11.988-40.265 and 5.170-33.333 respectively (allP < 0.05).Conclusions When septic shock patients were under low tissue perfusion (Lac > 8 mmol/L or PI ≤ 0.7%), the worse the tissue perfusion, the better the consistency between interstitial fluid glucose and arterial blood glucose; when septic shock patients were under normal local tissue perfusion (PI > 3.0%), the better the local tissue perfusion, the better the consistency between interstitial fluid glucose and arterial blood glucose.
