Glucose Monitoring
The Technology Challenge
Implementing blood glucose control strategies in critically ill patients have mostly been accomplished with manually operated portable whole blood glucose meters, which suffer from a variety of error sources that can put intensively managed patients at risk for insulin over– and/or under–dosing1. Furthermore, manually operated whole blood glucose monitoring lacks trending, while immediate feedback and predictability of the effects of insulin infusions are highly needed when infusing insulin in critically ill patients2. In addition, each blood glucose measurement requires a substantial volume of blood and is time–consuming3. Finally, automated or partially automated technologies that require the administration of heparin to a patient in order to produce serial glucose run the risk of Heparin-induced thrombocytopenia (HIT), the most frequent drug-induced, immune-mediated type of thrombocytopenia4.
OptiScan Biomedical Corporation has developed an automated, bedside glucose monitoring system to provide serial blood glucose measurements at 15 minute intervals for a wide range of glucose concentrations. The OptiScan system, called the OptiScanner, measures the infrared absorption of glucose in a very small sample of plasma, created from approximately 0.120 mL of a patient’s blood. No heparin is administered to the patient.
In the near future, the company intends to expand the capability of the technology by detecting additional analytes within the same blood sample, thereby providing additional information about the condition of a critically ill patient.
The Technology Challenge
Implementing blood glucose control strategies in critically ill patients have mostly been accomplished with manually operated portable whole blood glucose meters, which suffer from a variety of error sources that can put intensively managed patients at risk for insulin over– and/or under–dosing1. Furthermore, manually operated whole blood glucose monitoring lacks trending, while immediate feedback and predictability of the effects of insulin infusions are highly needed when infusing insulin in critically ill patients2. In addition, each blood glucose measurement requires a substantial volume of blood and is time–consuming3. Finally, automated or partially automated technologies that require the administration of heparin to a patient in order to produce serial glucose run the risk of Heparin-induced thrombocytopenia (HIT), the most frequent drug-induced, immune-mediated type of thrombocytopenia4.
OptiScan Biomedical Corporation has developed an automated, bedside glucose monitoring system to provide serial blood glucose measurements at 15 minute intervals for a wide range of glucose concentrations. The OptiScan system, called the OptiScanner, measures the infrared absorption of glucose in a very small sample of plasma, created from approximately 0.120 mL of a patient’s blood. No heparin is administered to the patient.
In the near future, the company intends to expand the capability of the technology by detecting additional analytes within the same blood sample, thereby providing additional information about the condition of a critically ill patient.
- Dungan K, Chapman J, Braithwaite SS, Buse J. Glucose measurement: confounding issues in setting targets for inpatient management.
Diabetes Care 2007:30:403-409. - Miller M, Skladany MJ, Ludwig CR, Guthermann JS. Convergence of continuous glucose monitoring and in-hospital tight glycemic control: closing the gap between caregivers and industry. J Diabetes Sci Technol 2007:1:903-906.
- Aragon D. Evaluation of nursing work effort and perceptions about blood glucose testing in tight glycemic control. Am J Crit Care 2006:15:370-377.
- Franchini M. Heparin-induced thrombocytopenia: an update. Thrombosis Journal 2005,3:14
