Comparison of Point-of-care and Laboratory Glucose Analysis in Critically Ill Patients.
From: Rex Healthcare in Raleigh, NC 27607, USA. teresita.lacara@rexhealth.com
American journal of critical care : an official publication, American Association of Critical-Care Nurses
- Publish Date: Jul 2007
- ISSN: 1062-3264
- Volume: 16
- Issue: 4
- Pages: 336-46; quiz 347
- Medium: Print
- Language: English
- Citation (JAMA): Lacara Teresita, Domagtoy Caroline, Lickliter Donna, et al. Comparison of Point-of-care and Laboratory Glucose Analysis in Critically Ill Patients.. Am. J. Crit. Care Jul 2007;16:336-46; quiz 347
Abstract
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 58-265) 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.
Mesh Headings (Keywords): Blood Glucose, Blood Pressure, Carbon Dioxide, Critical Illness, Diagnostic Techniques and Procedures, Education, Continuing, Hematocrit, Humans, Point-of-Care Systems, Southwestern United States
Check for Full Text / PubMed Unique Identifier (PMID): 17595363
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