Effectiveness and safety of the Space GlucoseControl system for glycaemia control in caring for postoperative cardiac surgical patients.

Abstract

BACKGROUND\nHyperglycaemia is a very common complication in post-cardiac surgical patients, and\xa0as such, it must be properly managed. For this purpose, the enhanced Model Predictive Control algorithm for glycaemia control has been implemented into a nurse-led device called Space GlucoseControl (SGC) that aims to achieve a safe and effective blood glucose control in a better way than the traditional paper-based protocols.\n\n\nPURPOSE\nThe aim of the study was to know the effectiveness and safety of the SGC in glycaemia control in cardiosurgical adult patients in the immediate postoperative period in the intensive care unit.\n\n\nMETHODS\nA prospective before-and-after intervention study was conducted. One hundred sixty cardiosurgical adult patients with hyperglycaemia were selected: 80 in the control group from May to November 2018 and 80 in the intervention group (use of the SGC device) from January to December 2019. The primary outcome was the percentage of time within the target range (140-180\xa0mg/dL in the control group and 100-160\xa0mg/dL in the intervention group).\n\n\nRESULTS\nThe percentage of time within the target range was significantly higher in the SGC group than in the control group (70.5% [58.25-80] vs 54.83% [36.09-75], p\xa0<\xa00.001). The range was also achieved earlier with the SGC (5 [3-6.875] hours vs 7 [4-11] hours; p\xa0<\xa00.05). The first blood glucose value after reaching the target range was higher in the control group, with statistical significance (p\xa0<\xa00.05). There were no\xa0hypoglycaemia episodes in the control group. However, during SGC treatment, six episodes of hypoglycaemia occurred, and all of them were nonsevere (mean value = 61\xa0mg/dL).\n\n\nCONCLUSION\nThe SGC is useful to achieve a faster tight glycaemic control, with a higher percentage of time within the target range, although episodes of nonsevere hypoglycaemia could be observed.