[Reliability of the measurement of glucose at the bedside of critical patients].
BACKGROUND
The objective of this study is to measure the reliability of three measurement methods at the bedside of the patient, of glucose in the critical patient compared with the measurement of glucose in the central laboratory.


METHODS
Observational, perspective study developed in a polyvalent unit of 18 beds for four months. Patients who had arterial catheter were included. Eight samples obtained at the patient's bedside were compared with the plasma glucose (gold Standard): three in capillary blood, four in arterial blood and one in arterial blood gases from a syringe. The measurements at bedside were conducted with reactive strips MediSense Optium Plus and glucometer MediSense Optium. A comparison was made of the means used in the Student's T test and Bland and Altman analysis.


RESULTS
We obtained 630 samples in 70 patients. Mean glucose (SD) in mg/dl was: a) capillary samples: 149 (38), 149 (35), 147 (37); b) arterial samples: 140 (34), 142 (35), 143 (35), 142 (34); arterial gas sample syringe: 143 (33); c) plasma glucose: 138(33). There were significant differences (p < 0.001) between plasma glucose and capillary samples but not with arterial samples (p=0.2). In the arterial samples, the presence of some factors, such as vasoactive drugs, glycated solution perfusion, insulin perfusion and plasma concentration of hemoglobin, increase error and dispersion regarding the gold standard.


CONCLUSIONS
The measurement of glucose at bedside in critical patients is more reliable in arterial samples than in capillary ones.
Arias-Rivera
S
S
Servicio de Cuidados Intensivos, Hospital Universitario de Getafe, Madrid, España. ariasrivera@eresmas.com
Copete-Vega
A
A
Vadillo-Obesso
P
P
Corrochano-Varas
S
S
Sánchez-Izquierdo
R
R
Sánchez-Sánchez
M M
MM
Sáiz-Sanz
A I
AI
Frutos-Vivar
F
F
Pascual-Durán
T
T
D000328:Adult; D000368:Aged; D001774:Blood Chemical Analysis / Q000295:instrumentation; D001786:Blood Glucose / Q000032:analysis*; D001800:Blood Specimen Collection; D002196:Capillaries; D016638:Critical Illness; D003920:Diabetes Mellitus / Q000097:blood; D005240:Feasibility Studies; D005260:Female; D006452:Hemoglobinometry; D006801:Humans; D006973:Hypertension / Q000097:blood; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D019095:Point-of-Care Systems; D011446:Prospective Studies; D014680:Veins
D001786:Blood Glucose