Retrospective Evaluation of the Accuracy of Roche AccuChek Inform and Nova StatStrip Glucose Meters when Used on Critically Ill Patients

Karon, Brad S.; Blanshan, Chanse T; Deobald, Gayle R; Wockenfus, Amy M.

doi:10.1089/dia.2014.0074

Cited by 28 publications

(22 citation statements)

References 18 publications

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“…Newer meter technologies may provide more accurate glucose measurement 12–14 when used on critically ill patients, though studies have not specifically addressed capillary sampling or use of meters intraoperatively. One previous study 33 specifically examined glucose measurements in the OR, although few patients were under anesthesia at the time of sample collection.…”

Section: Discussionmentioning

confidence: 99%

“…Though newer technologies may provide more accuracy 12–14 , there is still concern about the use of meters in the critically ill 15,16 . Studies have demonstrated potentially dangerous discrepancies in capillary glucose measurement in patients on vasopressor therapy 10,17 , patients in shock 18 or with poor tissue perfusion 19 , and in other critically ill patient populations 20 .…”

Section: Introductionmentioning

confidence: 99%

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Accuracy of Capillary and Arterial Whole Blood Glucose Measurements Using a Glucose Meter in Patients under General Anesthesia in the Operating Room

et al. 2017

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Background The aim of this study was to evaluate the use of a glucose meter with surgical patients under general anesthesia in the operating room. Methods Glucose measurements were performed intraoperatively on 368 paired capillary and arterial whole blood samples using a Nova StatStrip (Nova Biomedical, USA) glucose meter and compared with 368 reference arterial whole blood glucose measurements by blood gas analyzer in 196 patients. Primary outcomes were median bias (meter minus reference), percentage of glucose meter samples meeting accuracy criteria for subcutaneous insulin dosing as defined by Parkes error grid analysis for type 1 diabetes mellitus, and accuracy criteria for intravenous insulin infusion as defined by Clinical and Laboratory Standards Institute guidelines. Time under anesthesia, patient position, diabetes status, and other variables were studied to determine whether any affected glucose meter bias. Results Median bias (interquartile range) was −4 mg/dl (−9 to 0 mg/dl), which did not differ from median arterial meter bias of −5 mg/dl (−9 to −1 mg/dl; P = 0.32). All of the capillary and arterial glucose meter values met acceptability criteria for subcutaneous insulin dosing, whereas only 89% (327 of 368) of capillary and 93% (344 of 368) arterial glucose meter values met accuracy criteria for intravenous insulin infusion. Time, patient position, and diabetes status were not associated with meter bias. Conclusions Capillary and arterial blood glucose measured using the glucose meter are acceptable for intraoperative subcutaneous insulin dosing. Whole blood glucose on the meter did not meet accuracy guidelines established specifically for more intensive (e.g., intravenous insulin) glycemic control in the acute care environment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Accuracy of Capillary and Arterial Whole Blood Glucose Measurements Using a Glucose Meter in Patients under General Anesthesia in the Operating Room

et al. 2017

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“…Additional studies have reported similar findings in adult patient populations. (5, 16, 17) As such, the MAUDE database entry for BGMS-2 yielded only 28 total entries, with four erroneous measurements and no adverse events or deaths since the device’s release in 2006. One of these four erroneous BGMS-2 measurements was due user error where capillary fingerstick specimens were improperly obtained in a patient with severe hypotension.…”

Section: Discussionmentioning

confidence: 99%

“…Advances in biosensor technology have enabled the development of BGMS’s that autocorrect for these confounding factors. (5, 16–18) The unique autocorrecting features of recent BGMS’s are based on the simultaneous measurement of hematocrit and oxidizing/reducing substances during the testing process—allowing these biosensors to adjust for interferences. Additionally, these autocorrecting BGMS’s incorporate modified glucose oxidase enzymes that are not susceptible to the same oxygen tension affects found in older generation devices.…”

Section: Introductionmentioning

confidence: 99%

Clinical Impact of Accurate Point-of-Care Glucose Monitoring for Tight Glycemic Control in Severely Burned Children*

Tran

Godwin

Steele

et al. 2016

Pediatric Critical Care Medicine

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Objective The goal of this study was to retrospectively evaluate the clinical impact of an accurate autocorrecting blood glucose monitoring system (BGMS) in children with severe burns. BGMS accuracy is essential for providing appropriate intensive insulin therapy (IIT) and achieving tight glycemic control (TGC) in critically ill patients. Unfortunately, few comparison studies have been performed to evaluate the clinical impact of accurate BGMS monitoring in the high-risk pediatric burn population. Design Retrospective analysis of an electronic health record system. Setting Pediatric burn intensive care unit at an academic medical center. Patients Children (age<18 years) with severe burns (≥20% total body surface area [TBSA]) receiving IIT guided by either a non-correcting (BGMS-1) or an autocorrecting BGMS (BGMS-2). Measurements and Main Results Patient demographics, insulin rates, and BGMS measurements were collected. Frequency of hypoglycemia and glycemic variability was compared between the two BGMS groups. A total of 122 patient charts from 2001–14 were reviewed. Sixty-three patients received IIT using BGMS-1 and 59 via BGMS-2. Patient demographics were similar between the two groups. Mean insulin infusion rates (5.1±3.8 U/hour, n = 535 paired measurements vs. 2.4±1.3 U/hour, n = 511 paired measurements, P<0.001), glycemic variability, and frequency of hypoglycemic events (90 vs. 12, P<0.001) were significantly higher in BGMS-1 treated patients. Compared to laboratory measurements, BGMS-2 yielded the most accurate results (mean±SD bias: −1.7±6.9 mg/dL [−0.09±0.4 mmol/L] vs. 7.4±13.5 mg/dL [0.4±0.7 mmol/L]). BGMS-2 patients achieve glycemic control more quickly (5.7±4.3 hours vs. 13.1±6.9 hours, P<0.001) and stayed within the target glycemic control range longer compared to BGMS-1 patients (85.2±13.9% vs. 57.9±29.1%, P<0.001). Conclusions Accurate autocorrecting BGMS optimizes IIT, improves TGC, and reduces risk for hypoglycemia and glycemic variability. The use of an autocorrecting BGMS for IIT may improve glycemic control in severely burned children.

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“…Addressing the current regulatory focus on point-of-care (POC) glucose testing in the critically ill (2,11,12 ), a recent study compared retrospective performance of glucose meters in critically ill patients by use of POC and central laboratory events drawn within 5 min of each other (13 ). Such measurements constitute coincident testing events that can be harnessed for quality assessment.…”

mentioning

confidence: 99%

Postmarket Surveillance of Point-of-Care Glucose Meters through Analysis of Electronic Medical Records

Schroeder¹,

Giacherio²,

Gianchandani³

et al. 2016

Clinical Chemistry

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BACKGROUND:The electronic medical record (EMR) holds a promising source of data for active postmarket surveillance of diagnostic accuracy, particularly for pointof-care (POC) devices. Through a comparison with prospective bedside and laboratory accuracy studies, we demonstrate the validity of active surveillance via an EMR data mining method [Data Mining EMRs to Evaluate Coincident Testing (DETECT)], comparing POC glucose results to near-in-time central laboratory glucose results.

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Retrospective Evaluation of the Accuracy of Roche AccuChek Inform and Nova StatStrip Glucose Meters when Used on Critically Ill Patients

Cited by 28 publications

References 18 publications

Accuracy of Capillary and Arterial Whole Blood Glucose Measurements Using a Glucose Meter in Patients under General Anesthesia in the Operating Room

Accuracy of Capillary and Arterial Whole Blood Glucose Measurements Using a Glucose Meter in Patients under General Anesthesia in the Operating Room

Clinical Impact of Accurate Point-of-Care Glucose Monitoring for Tight Glycemic Control in Severely Burned Children*

Postmarket Surveillance of Point-of-Care Glucose Meters through Analysis of Electronic Medical Records

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