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Accuracy of Blood Glucose Measurement in Critically Ill Adult Patients: Presented at TCCMS By Danny Kucharsky TORONTO, CANADA -- November 2, 2005 -- Measuring the blood glucose of critically ill patients is more accurate when using arterial samples than capillary samples, according to a presentation at the 8th Annual Toronto Critical Care Medicine Symposium (TCCMS). The study used a comparative, within-subjects, repeated measures design to measure capillary and arterial blood glucose levels with 3 bedside glucose meters. Lead investigator Linda Slater-MacLean, TN, critical care instructor, University of Alberta Hospital, Edmonton, Alberta, Canada, said that recent evidence has shown the importance of maintaining normal blood glucose levels to reduce morbidity and mortality in critically ill patients. But, she added, "different analytical methods are not equally accurate for measuring blood glucose in capillary and arterial blood." Strategies aimed at maintaining normal blood glucose are seriously limited and increase the risk of hyperglycaemia, she said in her on October 26th presentation. The researchers recruited 60 patients from the medical/surgical intensive care unit at the University of Alberta Hospital. They collected matching capillary and arterial samples at about 8 a.m., noon, and 4 p.m., and analysed data only on the 45 of 60 subjects who had all of the matching capillary and arterial samples. Overall, 540 capillary and 675 arterial blood glucose measurements were tested using the Lifescan SureStepFlexx (BGM 1), Roche Accu-Chek Inform (BGM 2), and Abbott Freestyle (BGM 3), a point-of-care blood gas analyser (Bayer Chiron 865), and a reference blood glucose analyzer (YSI 2300 Stat Plus). In a comparison of capillary blood glucose values with the 3 blood glucose measurement tools and the blood glucose reference instrument, mountain bases ranged from -11% to +20% with BGM 1, from -17% to +9% with BGM 2, and from -5% to +20% with BGM 3. None of the medians representing the BGMs were close to zero. BGM 2 showed a negative bias, while BGM 1 and 3 showed a positive bias. A comparison of arterial blood glucose values using the 3 BGMs with the point-of-care blood gas analyzer and the blood glucose reference instrument found mountain bases ranging from -10% to +15% with BGM 1, from -19% to +3% with BGM 2, from -7% to +10% with BGM 3, and from -10% to +10% with the blood gas analyser. The median of BGM 3 and the point-of-care blood gas analyser were centred close to zero, while the median for BGM 2 showed a negative bias and the median for BGM 1 a positive bias. Dr. Slater-MacLean concluded that using arterial blood, the BGM 3, and the point-of-care blood gas analyser were highly accurate instruments for the measurement of arterial blood glucose. [Presentation title: An Evaluation of the Accuracy of Blood Glucose Measurement in Critically Ill Adult Patients.] E-mail this page to a friend or colleague! To print, use this version