Key result
Intravascular microdialysis accurately monitored continuous blood glucose during hypoglycemia in a porcine model, with 100% of samples in Clarke error grid region AB and a mean bias of -0.18 mg/dl.
Why the study?
Does intravascular microdialysis accurately measure continuous blood glucose during hypoglycemia in a porcine model?
Does intravascular microdialysis accurately measure continuous blood glucose during hypoglycemia in a porcine model?
Mean Difference: -0.18
Intravascular microdialysis in a central vein is an accurate and responsive method for continuous glucose monitoring during hypoglycemia in a porcine model.
Supports further development of intravascular microdialysis for CGM; leaves open human translation and clinical validation.
We have previously shown that intravascular microdialysis in a central vein is an accurate method for continuous glucose monitoring in patients undergoing cardiac surgery. However, no hypoglycemia occurred in our earlier studies, prompting further evaluation of the accuracy of intravascular microdialysis in the hypoglycemic range. Thus, this animal study was performed. A porcine model was developed; hypoglycemia was induced using insulin injections. The pigs were monitored with intravascular microdialysis integrated in a triple-lumen central venous catheter. As reference, venous blood gas samples were taken every 5 minutes and analyzed in a blood gas analyzer. Ethical permission for the animal experiments was obtained from the Stockholm Regional Ethical Committee, reference no N397/09. A total of 213 paired samples were obtained for analysis, and 126 (59.2%) of these were in the hypoglycemic range (<74 mg/dl). Using Clarke error grid analysis, 100% of the paired samples were in region AB and 99% in region A. The ISO standard (ISO15197) was met. Bland-Altman analysis showed bias (mean difference) ± limits of agreement was -0.18 ± 16.2 mg/dl. No influence from glucose infusions was seen. The microdialysis monitoring system was found to be very responsive in rapid changes in blood glucose concentration. This study shows that intravascular microdialysis in a central vein is an accurate method for continuous glucose monitoring in hypoglycemia in a porcine experimental model. Furthermore, the system was not influenced by glucose administration and was found to be responsive in rapid blood glucose fluctuations.
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Schierenbeck et al. (2014) studied Hypoglycemia. Intravascular microdialysis in a central vein vs. Venous blood gas samples was evaluated on Accuracy of continuous glucose monitoring (Clarke error grid analysis and Bland-Altman analysis) (bias -0.18 mg/dl). Intravascular microdialysis accurately monitored continuous blood glucose during hypoglycemia in a porcine model, with 100% of samples in Clarke error grid region AB and a mean bias of -0.18 mg/dl.
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