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RES2
Accuracy Of Glucose Point Of Care Testing: Fingerstick Or Arterial Catheter Blood?
By: Lacara, T., Domagtoy, C., Lickliter, D., Quattrocchi, K., Snipes, L., Kuszaj, J. & Prasnikar, M.; Rex Healthcare, Raleigh, NC
For further information, please contact: teresita.lacara@rexhealth.com
Purpose: This study examined the agreement between two sources of blood for glucose testing (arterial versus fingerstick) analyzed with a point of care (POC) testing device and laboratory glucose analysis in critically ill patients.
Background/Significance: Blood for POC testing is often obtained from a variety of sources: fingerstick, arterial and central venous catheters. The variability in glucose values between these different sources is not known.
Methods: A method-comparison study design was used to examine the agreement between two sources of blood for POC glucose testing (fingerstick and arterial catheter) and the laboratory method for glucose determination. Bias, precision, and root mean square differences (RMSD) were then calculated to quantify the differences between the POC and laboratory methods for glucose measurement. Multiple regression (MR) analysis was used to determine if serum CO2, mean arterial pressure (MAP) and/or hematocrit significantly contributed to the difference in bias and precision for the two POC testing methods. The level of significance was set at 0.05.
Results: A total of 42 subjects were evaluated. Laboratory analyzed glucose values ranged from 58 to 265 mg/dL. Differences and limits of agreement for the laboratory and two POC blood values were 1.0 ± 12.3, with RMSD of 12.23 for the fingerstick POC and laboratory glucose values and -0.1 ± 11.0 with RMSD of 10.9 for the arterial POC and laboratory glucose values. MR analysis found only hematocrit and serum CO2 levels to be significant contributors to difference scores between the laboratory and arterial POC analysis methods (F3,38 =7.96, p=0.0003). Conclusions: The study found that the bias and precision of glucose POC testing with a fingerstick sample was less accurate than samples obtained from an arterial catheter. In addition, at Hct and serum CO2 levels below normal ranges, arterial POC glucose testing tended to overestimate laboratory glucose values.
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