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RES200
Comparison of Capillary and Central Venous Point-of-Care Glucose Testing to a Venous Laboratory Gold Standard
By: R. Dela Rosa, M. Boehmer, M. Closs, J. Hamilton, K. Horton, M. McGrath, C. Schulman & A. Shearer; Providence St. Vincent Medical Center, Portland, OR
For further information, please contact: Rosalina.DelaRosa@providence.org
Purpose: To compare capillary Point of Care glucose testing (POC) and a central venous catheter sample POC to the gold standard of venous laboratory measurement.
Background/Significance: Critical Care nursing practice requires hourly glucose testing to titrate insulin infusions that maintain glucose levels within the desired range. While using blood obtained from a fingerstick sample is usually done, ICU nurses often perform the test using blood drawn from a central venous catheter. It is not clear which POC sample best correlates with the true blood glucose as measured in the lab.
Methods: A method-comparison study design was used to examine the agreement between different methods for blood glucose testing (POC and laboratory analysis) and difference sources of blood for testing (capillary and central venous).
Results: 63 subjects were studied. Significant differences were found between the venous and capillary POC glucose values and the laboratory glucose values (venous POC: t1,61 = 3.91, p=0.0002; capillary POC: t1,61 = 5.01, p=<0.0001). Comparison of the venous and capillary glucose values obtained with the POC device found no significant difference between the two values (t1,61 = -0.84, p=0.41). The number of individual difference scores between the POC and laboratory values which had glucose differences > 20 mg/dL were 13 out of 62 samples (21%) for venous POC and 12 out of 62 samples (20%) for capillary POC from the laboratory value.
Conclusions: Given the narrow range of glucose levels used for different treatment levels with insulin protocols, the accuracy of the POC device is not precise enough to justify use in these situations. Caution should be used when interpreting individual glucose readings obtained from a POC device.
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