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Suggestion to Manufacturers on Point-of-Care Meters

Thank you for the article by Cook et al¹ warning that significantly different results can be obtained when measuring blood glucose if the source is a fingerstick versus a central venous catheter. One revelation in the article was that "most POC glucose meters have an adjustment to correct glucose values from capillary blood to more closely approximate laboratory glucose values of venous blood."¹ Differences in these results have been the subject of scholarly debate for some time, but we must inject an element of realism: as long as there are critically ill patients without arterial lines, there are likely to be nurses who either are unaware of these differences, recognize the pain a fingerstick causes, or try to save time by using a point-of-care (POC) meter on blood they have already drawn for other purposes from a central venous line.

As this practice at the POC is unlikely to end, the solution is for manufacturers of all POC meters to eliminate the built-in correction—or, better yet, to add a function that allows the user to select the source of the blood: arterial, capillary, or peripheral or central venous. The meter would then make the required correction for each measurement. This improvement would apply to all POC meters no matter what they measure. I call on manufacturers to do just that.

FINANCIAL DISCLOSURES
None reported.

REFERENCE

1. Cook A, Laughlin D, Moore M, et al. Differences in glucose values obtained from point-of-care glucose meters and laboratory analysis in critically ill patients. Am J Crit Care. 2009;18(1):65–72.[Abstract/Free Full Text]

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