SAT095 Utilizing Continuous Glucose Monitoring Post Open Heart Surgery

Abstract

Abstract Disclosure: Y. Chen: None. A. Cuevas Velazquez: None. M.A. Wahab: None. K. Aljassani: None. K. Rajak: None. A. Halder: None. A. Atrash: None. J. Renu: None. Introduction: It is a standardized practice to monitor blood glucose (BG) levels while on insulin infusion therapy in patients who undergo open heart surgery regardless of their diabetes status. Hyperglycemia was often noted in these patients due to catecholamine surge induced by intraoperative stress. This study is to investigate whether using Continuous Glucose Monitoring (CGM) is a safer option compared to traditional finger stick (FS) glycemic monitoring in postoperative patients. Methods: This is a prospective randomized controlled trial. Patients planned for open heart surgery including coronary artery bypass surgery, valvular repair, or replacements at UPMC Harrisburg hospital from May 2021 to August 2022 were voluntarily involved and randomized by 2:1 ratio into CGM or FS glycemic monitoring methods during the first 48-hour postoperative period on insulin infusion therapy and in the intensive care unit (ICU). Patient demographics, comorbidities, diabetes (DM) status, and glycemic data within the first 48 hours after surgery were compared between the two groups. Results: A total of 42 patients were recruited, including 31 males (81.6%). Four patients were excluded due to missing data, 22 were randomized to the CGM group, and 16 to the FS group. There was no difference in demographics between the two groups. The mean glucose level of the CGM group (123.09 mg/dL) was no different from the FS group (116.31mg/dL) (p=0.09). The CGM group detected significantly more events of level 2 hypoglycemia (BG <54 mg/dL, p=0.01) and hyperglycemia (BG>=180 mg/dL, p=0.01) compared to the FS group. In the CGM group, the mean time of normoglycemia (BG 70-179 mg/dL), hypoglycemia, and hyperglycemia in all 22 patients was 91.1%, 2.58%, and 6.34% respectively. Time in normoglycemia was longer in non-DM patients (95.8%) than in DM patients (87.1%). Discussions: CGM signatures the convenience of frequent BG checks, enabling the reduction of glucose variability and improvement of glycemic control. In this study, although no difference was noted in the mean BG between CGM and FS groups, CGM was noted to be especially effective in hypoglycemia detection. Our findings suggest that CGM brings in the potential benefit of improving patient safety compared to traditional glucose monitoring. To conclude, CGM is probably non-inferior as a glucose monitoring method compared to FS and it might bring the additional benefit of improving patient safety by higher sensitivity of detecting significant hyper/hypoglycemic events for postoperative population on insulin drip in the ICU setting. Presentation: Saturday, June 17, 2023