ICUにおける経静脈的持続血糖測定器の使用経験

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  • Utilization of continuous intravenous monitoring apparatus for blood glucose in ICU

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It has been reported that strict control of blood glucose level reduces morbidity and mortality in critically ill patients. However, strict control of blood glucose level requires frequent measurements of blood glucose. Continuous blood glucose monitoring, therefore, may be useful for intensive insulin therapy to avoid frequent measurements. We report our experience of the bed-side artificial endocrine pancreas system “STG(R)-22” (Nikkiso Co. Ltd., Tokyo) and a comparison of intravenous blood glucose determined by this apparatus with arterial blood glucose level. The blood sampling device was successfully inserted intravenously in only two of six patients from whom informed consent was obtained.<br>Intravenous glucose level was significantly correlated with arterial blood glucose level (r=0.964). A significant negative correlation between intravenous and arterial glucose levels was found by analysis of a Bland-Altman plot (r=-0.5556). However, the discrepancy between intravenous and arterial blood glucose levels is attributed to physiological conditions, not mechanical characteristics. Some problems such as the large size of the apparatus, limitation of length of the sampling circuit and large volume of blood sampling should be resolved for this apparatus to be used easily and safely for monitoring continuous blood glucose in ICU.

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