Sammanfattning
Background: Critically ill patients who receive glucose/insulin treatment need close glucose control. Point-of-care testing (POCT) devices are commonly used to monitor blood glucose levels. The purpose of our study was to see if capillary glucose measured with a POCT device was acceptable for this group of patients.
Material and Methods: Glucose values obtained with POCT devices Accu-Chek Performa and Ascensia Contour from fingerstick. The values were compared with arterial/venous glucose values obtained by laboratory analysis (Modular) and a bloodgass instrument (ABL 725). In adittion hematocrit (hct) was measured and 26 samplings were included.
Result: Mean glucose obtained by Accu-Chek Performa and Ascensia Contour was 7,9 (4,8-15,8) and 8,1 (4,6-16,7) mmol/L. Mean glucose was 8,6 (4,3-17,4) and 8,6 (4,6-17,1) mmol/L from the laboratoty (Modular) and from the bloodgas instrument (ABL 725). Significant differences were found between glucose values obtained by the POCT devices and by the reference laboratory methods (p<0,05). POCT devices do not satistfy the requirements from ISO 15197. Low hematocrit values (HCT < 0,40) underestimated the glucose values by 10 %.
Conclusion: Under standardised conditions there was a significant difference between the glucose results obtained by use of POCT devices and those obtained by reference laboratory methods. POCT devices do not satisfy accuracy requirements and the glucose values are underestimated for patients with low hematocrit. Therefore it is uncertain as to whether PNA devices are precise enough to be used on critically ill patients.