Accuracy of point-of-care blood glucose measurements in the medical ICU

Introduction

Accurate blood glucose measurement is essential for strict glycemic control. We evaluated four methods of point-of-care blood glucose measurement in critically ill patients.

Methods

In this prospective observational study, blood glucose was measured with the Roche Accu-Chek (capillary and arterial), the Radiometer ABL-700 analyzer (arterial), and in the central laboratory (arterial). Each value was compared with the reference laboratory result. Discrepancy was defined as the percentage of paired values not in accordance (>0.83 mmol/l difference for laboratory values <4.12 mmol/l, and >20% difference for values ≥ 4.12 mmol/l).

Results

The mean value, bias, agreement and discrepancy are presented in Table 1.

Table 1

Conclusion

Our findings suggest that capillary blood glucose measured by a glucometer is inaccurate in critically ill medical patients. Fingerstick measurements should be interpreted with great caution to avoid hypoglycemia.