Use of arterial blood with bedside glucose reflectance meters in an intensive care unit

Maser, Raelene E.; Butler, Margaret; DeCherney, G. Stephen

doi:10.1097/00003246-199404000-00014

Cited by 66 publications

(33 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Conversely, when the total error is kept below 10% dosing errors are virtually avoided. Moreover, titrating insulin infusions on results from such inaccurate blood glucose meters induces undetected severe hypoglycemia and unacceptably high blood glucose variability [31]. Repeated and large (undetected) fluctuations in blood glucose with hypoglycemia alternating with hyperglycemia in ill patients may also be worse than tolerating constant moderate hyperglycemia [32,33].…”

Section: Is Nice-sugar Evidence Against Blood Glucose Control?mentioning

confidence: 99%

Glycemic Targets and Approaches to Management of the Patient with Critical Illness

Mesotten

Berghe

2011

Curr Diab Rep

View full text Add to dashboard Cite

Hyperglycemia during critical illness is associated with adverse outcome. The proof-of-concept Leuven studies assessed causality, and revealed that targeting strict normoglycemia (80-110 mg/dL) with insulin improved outcome compared with tolerating hyperglycemia to the renal threshold (215 mg/dL). A large multicenter trial (NICE-SUGAR [Normoglycaemia in Intensive Care Evaluation and Survival Using Glucose Algorithm Regulation]) found an intermediate blood glucose target (140-180 mg/dL) safer than targeting normoglycemia. Differences in design and in execution of glycemic control at the bedside may have contributed to these results. In NICE-SUGAR (Normoglycaemia in Intensive Care Evaluation and Survival Using Glucose Algorithm Regulation), the blood-glucose target range in the control group was lower, there were problems to reach and maintain normoglycemia in the intervention group, and inaccurate handheld blood glucose meters and variable blood sampling sites were allowed. Inaccurate tools led to insulin-dosing errors with consequently (undetected) hypoglycemia and unacceptable blood glucose variability. Also, the studies were done superimposed upon different nutritional strategies. Thus, such differences do not allow simple, evidence-based recommendations for daily practice, but an intermediate blood glucose target may be preferable while awaiting better tools to facilitate safely reaching normoglycemia.

show abstract

Section: Is Nice-sugar Evidence Against Blood Glucose Control?mentioning

confidence: 99%

Glycemic Targets and Approaches to Management of the Patient with Critical Illness

Mesotten

Berghe

2011

Curr Diab Rep

View full text Add to dashboard Cite

show abstract

“…4,5 Numerical formulae for Hct correction have been proposed in some previous articles. 6,7 In 2007, a new type of BG meter equipped with an Hctcorrecting feature was developed in Japan; however, its effectiveness has not yet been confirmed.…”

Section: Introductionmentioning

confidence: 99%

Glutest Neo Super—a New Handheld Blood Glucose Meter—Corrects for the Effects of the Hematocrit Values in Both Hematocrit-Adjusted Samples and Samples Obtained from Anemic Patients

Yakushiji

Fujita

Suzuki

et al. 2009

Diabetes Technology & Therapeutics

View full text Add to dashboard Cite

show abstract

“…Studies in the literature, using different devices, have shown significant Cgluc-strip errors and have suggested that such measurements should not be used in cases of critically ill patients. 12,[16][17][18]25 This downplays the idea that the error in glucose value measurement using a glucometer could possibly be related to the type of device used. Laboratory interference variables were eliminated.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of different methods for blood glucose measurement in critically ill patients

et al. 2009

View full text Add to dashboard Cite

CONTEXT AND OBJECTIVE: Although glucometers have not been validated for intensive care units, they are regularly used. The aim of this study was to compare and assess the accuracy and clinical agreement of arterial glucose concentration obtained using colorimetry (Agluc-lab), capillary (Cgluc-strip) and arterial (Agluc-strip) glucose concentration obtained using glucometry and central venous glucose concentration obtained using colorimetry (Vgluc-lab). DESIGN AND SETTING:Cross-sectional study in a university hospital.METHOD: Forty patients with septic shock and stable individuals without infection were included. The correlations between measurements were assessed both in the full sample and in subgroups using noradrenalin and presenting signs of tissue hypoperfusion. RESULTS:Cgluc-strip showed the poorest correlation (r = 0.8289) and agreement (-9.87 ± 31.76). It exceeded the limits of acceptable variation of the Clinical and Laboratory Standards Institute in 23.7% of the cases, and was higher than Agluc-lab in 90% of the measurements. Agluc-strip showed the best correlation (r = 0.9406), with agreement of -6.75 ± 19.07 and significant variation in 7.9%. For Vgluc-lab, r = 0.8549, with agreement of -4.20 ± 28.37 and significant variation in 15.7%. Significant variation was more frequent in patients on noradrenalin (36.4% versus 6.3%; P = 0.03) but not in the subgroup with hypoperfusion. There was discordance regarding clinical management in 25%, 22% and 15% of the cases for Cgluc-strip, Vgluc-lab and Agluc-strip, respectively.CONCLUSION: Cgluc-strip should be avoided, particularly if noradrenalin is being used. This method usually overestimates the true glucose levels and gives rise to management errors. CLINICAL TRIAL REGISTRATION: ACTRN12608000513314 (registered as an observational, cross-sectional study)RESUMO CONTEXTO E OBJETIVO: Apesar de glicosímetros não serem validados para unidades de terapia intensiva (UTI), seu uso é corriqueiro. O objetivo foi avaliar a acurácia e concordância clínica entre a glicemia arterial por colorimetria (glicA-lab), glicemias capilar (glicC-fita) e arterial (glicA-fita) por glicosimetria, e venosa central por colorimetria (glicV-lab). TIPO DE ESTUDO E LOCAL: Estudo transversal realizado em hospital universitário.MÉTODO: Foram incluídos 40 pacientes com choque séptico e indivíduos estáveis, sem infecção. A correlação entre medidas foi avaliada tanto na amostra global quanto nos subgrupos em uso de noradrenalina e com sinais de hipoperfusão tecidual. RESULTADOS:A glicC-fita mostrou pior correlação (r = 0,8289) e concordância (-9,87 ± 31,76). Esta superou os limites aceitáveis de variação do Clinical and Laboratory Standards Institute em 23,7% dos casos, sendo maior que a glicA-lab em 90% das vezes. A glicA-fita teve a melhor correlação (r = 0,9406), com concordância de -6,75 ± 19,07 e variação significativa em 7,9%. Para a glicV-lab, obteve-se r = 0,8549, concordância de -4,20 ± 28,37 e variação significativa em 15,7%. Variação significativa foi mais frequente em pacient...

show abstract

Use of arterial blood with bedside glucose reflectance meters in an intensive care unit

Cited by 66 publications

References 0 publications

Glycemic Targets and Approaches to Management of the Patient with Critical Illness

Glycemic Targets and Approaches to Management of the Patient with Critical Illness

Glutest Neo Super—a New Handheld Blood Glucose Meter—Corrects for the Effects of the Hematocrit Values in Both Hematocrit-Adjusted Samples and Samples Obtained from Anemic Patients

Accuracy of different methods for blood glucose measurement in critically ill patients

Contact Info

Product

Resources

About