Reliability of arterial, capillary and venous point-of-care glucose measurements in the intensive care unit setting: evaluation of two glucometers

Introduction

Increased risk of hypoglycemia is the major drawback of strict glycemic control, which has been extensively used in critically ill patients. Fast and precise glucose measurements are therefore mandatory. Our aim was to evaluate the accuracy of two methods of bedside point-of-care testing for glucose measurements using arterial, capillary and venous blood samples in ICU patients.

Methods

A cross-sectional study with prospective data collection included 86 patients admitted to a 40-bed clinical-surgical ICU of a tertiary care hospital. Results from two different methods of glucose measurement were compared with central laboratory arterial blood measurements: Accu-chek Advantage^® (Roche) arterial, venous and capillary samples; and Precision PCx^® (Abbott) arterial samples. All samples were collected simultaneously. Agreement between measurements was tested with the Bland–Altman method.

Results

Comparisons between pairs of measurements are shown in Figure 1.

Figure 1

(abstract P140)

Conclusion

The two glucose meters evaluated might not be sufficiently reliable to be used in the ICU setting, especially for patients under strict blood glucose control. Moreover, there are marked differences between the equipment and a decrease in precision if capillary or venous samples are used.