Validación de un glucómetro en una unidad de cuidados intensivos

López, Miguel Ángel Castaño; Serrano, José Luis Fernández; Rodríguez, José Luis; Márquez, Tomas Márquez

doi:10.1016/j.endonu.2011.08.003

Cited by 4 publications

(3 citation statements)

References 27 publications

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“…However, this percentage may be close to the usual practice in intensive care units because figures around 4% have been reported in a multicentre survey made in Brazil 27 . Second, although the use of glucose meters has been validated in the ICU in several studies, 8,9 the gold standard is still arterial blood gas measurement. We did not compare both types of analysers in order not to modify the routine practice of our unit and minimize blood loss, as we do not have blood‐saving devices.…”

Section: Discussionmentioning

confidence: 99%

“…The Surviving Sepsis Campaign (SSC) recommends the use of arterial blood for glucose measurement, whether performed with glucose meters or gas analysers and interprets the results of capillary samples with caution 7 . The measurement of blood glucose using glucose meters in arterial blood is non‐inferior to that performed with blood gas analysers 8 and plasma samples sent to the laboratory 9 …”

Section: Introductionmentioning

confidence: 99%

“…7 The measurement of blood glucose using glucose meters in arterial blood is non-inferior to that performed with blood gas analysers 8 and plasma samples sent to the laboratory. 9 There is great variability in the blood sample type used for comparisons. An integrative review 10 of 17 studies reports the following results: venous and capillary (six), arterial and capillary (four), another four on arterial samples only, arterial, and venous (two), central versus peripheral venous (two); and only one compared the three different blood samples: arterial, venous, and capillary.…”

Section: Introductionmentioning

confidence: 99%

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Agreement of blood glucose measured with glucose meter in arterial, central venous, and capillary samples in adult critically ill patients

Rodriguez-Delgado

Moral

Cobos‐Vargas

et al. 2021

Nursing in Critical Care

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Background: The measurement of blood glucose in critically ill patients is still performed in many ICUs with glucose meters and capillary samples. Several prevalent factors in these patients affect the accuracy of the results and should be interpreted with caution. A weak recommendation from the Surviving Sepsis Campaign (SSC) suggests the use of arterial blood rather than capillary blood for point of care testing using glucose meters. Aims and objectives: To analyse the agreement between arterial, central venous, and capillary blood samples of glucose values measured by glucose meter in critically ill patients and study potential confounding factors. Design: Prospective cross-sectional study in a general intensive care unit (ICU). Patients needing insulin treatment (subcutaneous or intravenous) and blood glucose control were included. Methods: Standardized collection of blood samples and measurement of glucose values with a glucometer. Agreement was studied by the Bland-Altman method and stratified analysis of disagreement-survival plots was used to study the influence of haematocrit, pH range, SOFA score, capillary refilling time, intravenous insulin infusion, and lactic acid.Results: A total of 297 measurements from 54 patients were included. The mean arterial blood glucose was 150.42 (range 31-345 mg/dL). In the graphical analysis, there is a poor agreement both in capillary and venous central to arterial samples, but in opposite direction (underestimation of capillary and overestimation of central venous). Factors associated with a reduction in the agreement between arterial and capillary samples were elevated lactate, poor capillary refilling, and hemodynamic failure. Patients without hemodynamic compromise have an acceptable agreement with values for absolute differences of 16 mg/dL for a disagreement of 10%. Conclusions:In critically ill patients, the measurement of blood glucose with a glucose meter should be performed with arterial samples whenever possible. Capillary samples do not accurately estimate arterial blood glucose values in patients with

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Section: Discussionmentioning

confidence: 99%