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Corresponding author: Teresita Lacara, RN, BSN, Intensive Care Unit, Rex Healthcare, 4424 Lake Boone Trail, Raleigh, NC 27607 (e-mail: teresita.lacara{at}rexhealth.com).
Background Blood for point-of-care analysis of glucose levels is often obtained from different sources (fingerstick, arterial or central venous catheter).
Objectives To examine agreement between point-of-care and laboratory glucose values and to determine effects of hematocrit, serum carbon dioxide, and mean arterial pressure on the accuracy of point-of-care values.
Methods Point-of-care values were compared with laboratory values. In 49 critically ill patients, blood was obtained first from a catheter for laboratory testing and then from the catheter and via fingerstick for point-of-care testing. Bias, precision, and root-mean-square differences were calculated to quantify differences in values between the 2 methods. A t test was used to determine differences in values between each point-of-care blood source and the laboratory value. Multiple regression analysis was used to determine if serum level of carbon dioxide, hematocrit, and/or mean arterial pressure significantly contributed to the difference in bias and precision for the point-of-care blood sources.
Results Mean laboratory glucose level was 135 (SEM 5.3, range 58265) mg/dL. In point-of-care testing, bias ± precision and root-mean-square differences were 2.1 ± 12.3 and 12.35, respectively, for fingerstick blood and 0.6 ± 10.6 and 10.46 for catheter blood. Values for point-of-care and laboratory tests did not differ significantly. For catheter samples, hematocrit and serum carbon dioxide contributed significantly to difference scores between point-of-care and laboratory values (P < .001).
Conclusions Glucose values for point-of-care samples did not differ significantly from laboratory values. For catheter samples, hematocrit and serum carbon dioxide levels accounted for the difference between point-of-care and laboratory glucose values.
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E. A. Mann, H. F. Pidcoke, J. Salinas, C. E. Wade, J. B. Holcomb, S. E. Wolf, T. Lacara, C. Domagtoy, D. Lickliter, K. Quattrocchi, et al. Accuracy of Glucometers Should Not Be Assumed Am. J. Crit. Care., November 1, 2007; 16(6): 531 - 532. [Full Text] [PDF] |
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