Performance assessment of a glucose control protocol in septic patients with an automated intermittent plasma glucose monitoring device

Clin Nutr. 2014 Oct;33(5):867-71. doi: 10.1016/j.clnu.2013.10.007. Epub 2013 Oct 23.


Background & aims: The optimal level and modality of glucose control in critically ill patients is still debated. A protocolized approach and the use of nearly-continuous technologies are recommended to manage hyperglycemia, hypoglycemia and glycemic variability. We recently proposed a pato-physiology-based glucose control protocol which takes into account patient glucose/carbohydrate intake and insulin resistance. Aim of the present investigation was to assess the performance of our protocol with an automated intermittent plasma glucose monitoring device (OptiScanner™ 5000).

Methods: OptiScanner™ was used in 6 septic patients, providing glucose measurement every 15' from a side-port of an indwelling central venous catheter. Target level of glucose was 80-150 mg/dL. Insulin infusion and kcal with nutritional support were also recorded.

Results: 6 septic patients were studied for 319 h (1277 measurements); 58 [45-65] hours for each patient (measurements/patient: 231 [172-265]). Blood glucose was at target for 93 [90-98]% of study time. Mean plasma glucose was 126 ± 11 mg/dL. Only 3 hypoglycemic episodes (78, 78, 69 mg/dL) were recorded. Glucose variability was limited: plasma glucose coefficient of variation was 11.7 ± 4.0% and plasma glucose standard deviation was 14.3 ± 5.5 mg/dL.

Conclusions: The local glucose control protocol achieved satisfactory glucose control in septic patients along with a high degree of safeness. Automated intermittent plasma glucose monitoring seemed useful to assess the performance of the protocol.

Keywords: Automated glucose control; Blood glucose; Critically ill patients; Glucose control protocol; Sepsis.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Blood Glucose / metabolism*
  • Blood Glucose Self-Monitoring / instrumentation*
  • Blood Glucose Self-Monitoring / methods
  • Body Mass Index
  • Critical Illness
  • Female
  • Humans
  • Hyperglycemia / blood
  • Hyperglycemia / drug therapy
  • Hypoglycemia / blood
  • Hypoglycemia / drug therapy
  • Hypoglycemic Agents / administration & dosage
  • Insulin / administration & dosage
  • Intensive Care Units
  • Male
  • Middle Aged
  • Pilot Projects
  • Prospective Studies
  • Sepsis / blood*


  • Blood Glucose
  • Hypoglycemic Agents
  • Insulin