Background and aims: The glycemic stability is of great importance during critical care, because both hyper- and hypoglycemia are associated with increased mortality. The continuous subcutaneous glucose monitoring system (CGM) was developed for diabetic patients, however, it has a potential role in critical care. Aims: The aim of our study was to evaluate the accuracy of CGM in pediatric patients needing intensive care. Methods: Clinical data: n=38, mean age (range): 1.3(0–18) years; gender: 10 females; length of PICU stay: 21(1–80) days; 32/38 patients needed mechanical ventilation; 11/38 needed vasoactive therapy. Subcutaneous glucose level was monitored by Guardian® REAL Time (Medtronic). Reference glucose values were obtained by GEM Premier 3000 blood gas analyzer (Instrumentation Laboratory) or point-of-care glucose analyzer (DCONT Ideal, 77 Elektronika). Calibration was performed at least twice a day. Approved by the IRB. Results: A total of 4199 hours of CGM recordings were analyzed. Calibration was performed 555 times. 225 blood gas recordings were archived without calibration. Pearson’s correlation coefficient was 0.83. Based on the Clarke Error Grid analysis, the clinical accuracy was 96% (zone A+B). None of the glucose pairs fell in field C or E. Bland Altman analysis: the mean difference between reference and CGM glucose levels was 2.4 mg/dL, (SD: 22 mg/dL). In 48 cases the differences were over the 2SD, in five cases over 80 mg/dL. Conclusions: We conclude that CGM is a reliable tool for glucose monitoring in pediatric intensive care, however, the diagnostic use of CGM may be restricted by possible incoherence of subcutaneous and intravascular glucose levels.
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