Continuous Glucose Monitoring by Subcutaneous Measurement Compared to Frequent Point of Care Measurement by Accu Chek in Critically Ill Patients (RESCUEII)
Continuous Glucose Monitoring by Subcutaneous Measurement Compared to Frequent Point of Care Measurement by Accu Chek in Critically Ill Patients; a Randomized Controlled Trial (RESCUEII)
Studieöversikt
Status
Betingelser
Intervention / Behandling
Detaljerad beskrivning
Most patients admitted to the ICU are treated with intensive insulin therapy, according to a locally developed glucose treatment protocol. The use of a continuous glucose monitoring in critically ill patients could have the following advantages:
- Better insight in the alterations of the blood glucose levels
- Early detection of hypoglycemia's or hyperglycaemia's, and subsequently more stable glycemic levels.
- Fewer blood samples
- Decreased workload for the nursing staff
In this study, patients will be randomized in: 1. The Freestyle group or 2. The AccuChek Group.
Patients in both groups will receive a Freestyle Navigator device, which will stay on the patient up to 5 days, or until discharge from the ICU.
The medical treatment of both study groups will be equal, except for the frequency of the glucose level measurements and the resulting adjustments according to the treatment protocol. In the Freestyle group extra glucose level measurements will be made in response to alarms from the device.
In both groups, every 4 hours blood glucose values will be obtained using a blood gas analyzer (BGA). When a control measurement by BGA results in a glucose level of <2.2 or >25 mmol/l, the value will be transmitted to the Patient Data Management System (PDMS) and gives an alarm. Otherwise, the value will be blinded in the PDMS.
Freestyle Navigator data will be downloaded from the device. Blood glucose values obtained in the course of usual care will be compared with time-matched Freestyle Navigator values to assess device accuracy.
Studietyp
Inskrivning (Faktisk)
Fas
- Inte tillämpbar
Kontakter och platser
Studieorter
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Amsterdam, Nederländerna
- Onze Lieve Vrouwe Gasthuis
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Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
Inclusion Criteria:
- ICU-patients > 18 years
- Expected length of stay on the ICU > 24 hours
- Indication for glucose regulation with insulin (according to the current glucose treatment protocol)
- Availability of the Freestyle Navigator
Exclusion Criteria:
- Participation in another trial subject to the WMO
- Lack of informed consent
- Contraindication for the use of the Accu Chek (for example peritoneal dialysis, Ht <0,20 of > 0,65; paracetamol intoxication)
- Contraindication for placement of the subcutaneous glucose sensor
- Participation in this trial during previous ICU admittance
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Diagnostisk
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
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Experimentell: Freestyle group
Glucose levels are being monitored with the Freestyle Navigator up to 5 days, or until discharge from the ICU
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Continuous glucose monitoring by subcutaneous measurement in the interstitial fluid
Andra namn:
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Aktiv komparator: AccuChek group
Glucose levels are being measured by the AccuChek.
Patients also get a Freestyle Navigator, which will be blinded.
The device will stay on the patient up to 5 days, or until discharge from the ICU.
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Continuous glucose monitoring by subcutaneous measurement in the interstitial fluid
Andra namn:
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Vad mäter studien?
Primära resultatmått
Resultatmått |
|---|
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Number of severe hyperglycaemias and hypoglycaemias with blood glucose levels >25 mmol/l and <2.2 mmol/l
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Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
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Dödlighet
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Length of stay in the ICU
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Time duration that the blood glucose levels of a patient are within the 'target range' (measured with the freestyle Navigator®)
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The target range in the ICU of the OLVG is set between 5 and 9 mmol/l according to the local treatment protocol
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Time duration that the blood glucose levels of a patient are under and above the 'target range' (measured with the freestyle Navigator®)
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The target range in the ICU of the OLVG is set between 5 and 9 mmol/l according to the local treatment protocol
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- Variability of the glycemic levels by arterial measuring with the blood gas analyzer (BGA), determined by the Mean Absolute Glucose change per hour (MAG)
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Mean Absolute Glucose change per hour: ΔBGA / Δtime The MAG is calculated by taking the sum of all absolute glucose changes during admission (measured by BGA) and dividing this by the total time spent in the ICU in hours. |
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False positive frequency of alarms of the Freestyle Navigator®
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Verified by the glucose level measurements by blood gas analyzer
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Number of undesirable low glucose levels per 24 hours
Tidsram: 24 hours
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blood glucose levels between 2,5 and 5 mmol/l
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24 hours
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Number of missed hypoglycemia's with the AccuChek (measured with the Freestyle Navigator®)
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Number of blood samples per day
Tidsram: 24 hours
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24 hours
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Samarbetspartners och utredare
Sponsor
Utredare
- Huvudutredare: P HJ van der Voort, MD, PhD, Onze Lieve Vrouwe Gasthuis
Publikationer och användbara länkar
Studieavstämningsdatum
Studera stora datum
Studiestart
Primärt slutförande (Faktisk)
Avslutad studie (Faktisk)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Uppskatta)
Uppdateringar av studier
Senaste uppdatering publicerad (Uppskatta)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
- NL33495.100.10
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