Relative accuracy of arterial and capillary glucose meter measurements in critically ill patients

Diabetes Metab. 2012 Jun;38(3):230-5. doi: 10.1016/j.diabet.2011.12.003. Epub 2012 Feb 18.

Abstract

Aim: As optimizing glucose control in critically ill patients remains a challenge for intensive-care physicians, this study aimed to determine the accuracy of glucose measurements.

Methods: The accuracy of capillary and arterial blood glucose meter measurements was compared with central laboratory arterial glucose measurements; the factors associated with inaccurate measures were also determined.

Results: Altogether, 302 samples from 75 patients were assessed. Mean glucose levels were 126±52 mg/dL for capillary measurements, 133±50 mg/dL for arterial measurements and 143±54 mg/dL for serum glucose laboratory measurements. Compliance with the ISO 15197 guidelines was observed in 74.8% of the capillary samples and 88.7% of the arterial samples. However, all measurements by glucose meter (with either capillary or arterial samples) led to underestimations of serum glucose.

Conclusion: In critically ill patients, glucose measurements from capillary and arterial blood by glucose meter are inaccurate, and can potentially lead to inappropriate use of insulin-infusion protocols and failure to achieve glycaemic targets.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Arteries*
  • Blood Glucose / metabolism*
  • Capillaries*
  • Critical Care / methods
  • Critical Illness*
  • Diabetes Mellitus / blood*
  • Diabetes Mellitus / drug therapy
  • Female
  • Humans
  • Infusions, Intravenous
  • Insulin / administration & dosage
  • Insulin / blood*
  • Male
  • Middle Aged
  • Monitoring, Physiologic / methods*
  • Point-of-Care Systems / standards
  • Predictive Value of Tests
  • Reproducibility of Results

Substances

  • Blood Glucose
  • Insulin