Bedside capillary blood glucose measurements in critically ill patients: Influence of catecholamine therapy
Received 11 June 2009; received in revised form 13 September 2009; accepted 17 September 2009. published online 26 October 2009.
Abstract
Objective
To evaluate the effects of catecholamine therapy on the accuracy of capillary glucose measurements in hyperglycemic patients.
Participants
43 hyperglycemic patients older than 18 years admitted to the intensive care unit of a tertiary medical center were included from December 2005 to March 2006.
Measurements
This prospective study compares fingerstick and earlobe measurements simultaneously to sampled laboratory venous glucose in patients treated without (group 1) or with (group 2) catecholamine. Three venous samples for serum glucose analysis at three fixed hours and simultaneously two capillary glucose determinations were performed during the two first successive days after inclusion. A difference between the methods of glucose measurements greater than 2.3mmol/l was considered significant.
Results
The mean difference between the two methods was −0.05mmol/l in group 1 and +0.29mmol/l in group 2, while the limits of agreement were +4.03 and −4.13mmol/l and +5.63 and −5.05mmol/l in groups 1 and 2, respectively. A difference between paired measurements greater than 2.3mmol/l was observed in 29% in group 1 and in 40% in group 2 (p=0.038). The alternative site did not improve the accuracy.
Conclusions
In critically ill patients treated with catecholamine capillary fingerstick blood glucose measurement seems inaccurate. Earlobe sampling does not improve accuracy.
ABSTRACT