Performance of continuous glucose monitoring in patients with acute respiratory failure: a prospective, single-center observational study.

OBJECTIVE: Continuous glucose monitoring (CGM) may have benefits in achieving glycemic control in critically ill patients. The aim of this study was to assess the accuracy of the Freestyle Libre H (professional version of the Libre Pro). in patients with acute respiratory failure (ARF) in the intensive care unit (ICU). METHODS: 52 adult patients with ARF were selected. The performance of CGM was evaluated using arterial blood glucose (aBG) and point-of-care (POC) glucose as reference values. Numerical accuracy was evaluated by the mean absolute relative difference (MARD), Bland-Altman analysis, and %15/15(the percentage of CGM values within 15 mg/dL or 15% of reference values <100 mg/dL or >100mg/dL, respectively), %20/20 and %30/30; Clinical accuracy was assessed by Clarke error grid analysis. RESULTS: 519 and 1504 pairs of aBG/CGM and POC/CGM glucose values were analyzed. The MARD values were 13.8% and 14.7%, respectively. The mean deviation of the Bland‒Altman analysis was 0.82 mmol/L and 0.81 mmol/L. %15/15, %20/20 and %30/30 of aBG values were 62.6%, 75.5%, and 92.4%, respectively; %15/15, %20/20 and %30/30 of POC values were 57.1%, 72.9%, and 88.7%, respectively. The Clarke error grid analysis showed that 97.8% and 99.3% of the values located in the (A+B) zone. Additionally, accuracy of CGM is not affected by general patient factors. CONCLUSION: This study demonstrated that the accuracy of CGM in patients with ARF is lower than that in most outpatients, and it is not affected by general patient factors. Whether CGM is beneficial to glucose management in ICU needs further evaluation.

[Development of the comprehensive geriatric assessment scale for Chinese elderly].

OBJECTIVE: To establish a comprehensive geriatric assessment scale which fit the situations of Chinese old people most, and to provide an evaluation tool for the proposal and intervention of functional health problems for the elderly. METHODS: The comprehensive geriatric assessment scale was produced by Delphi method combing with Chinese cultural background, some methods such as literature review and experts evaluation were conducted. The manuscript of this questionnaire was developed through Delphi and pre-experiment. Then the manuscript questionnaires were used among 300 old people, to analyze and assess the reliability, validity and reactivity. RESULTS: The experiment analysis demonstrated that the total Cronbach alpha coefficient was 0. 909 and that of each index ranged from 0.718-0.960, most of the dimension-related coefficients were over 0.5. The construct validity was validated by factor analysis and the cumulative contribution rate was up to 76.88%. Results of non-parametric test on reactivity showed that the differences of total scores and each dimension' scores and substitute scores between the elderly from different institutions were statistically significant (P < 0.01). CONCLUSION: The comprehensive geriatric assessment scale owns a reasonable reliability, validity and reactivity, and this scale can be used as an evaluation instrument for the finding and intervention of the elder's health problems.