Reliability assessment of glucose measurement by HemoCue analyser in a neonatal intensive care unit.
BACKGROUND
Rapid and reliable bed-side determination of blood glucose concentration is very important in the management of acutely ill infants and especially in premature newborns. HemoCue is an easy-to-use glucose analyser. The aim of the present study was to examine the usefulness of the HemoCue glucose analyser compared to a reference plasma glucose method (SYS, BM/Hitachi 747/737) in a neonatal intensive care unit (NICU).


METHODS
Seventy-eight consecutive neonates admitted to our NICU were enrolled in the study. At the time of the study all patients were grouped according to nutritional management (parenteral or enteral nutrition), haematocrit values and birth weight. The effects of feeding management, haematocrit values, and birth weight on accuracy and precision of the device were evaluated.


RESULTS
Overall data linear regression analysis yielded an r-value of 0.905 and the Bland-Altman method demonstrated that HemoCue overestimates plasma glucose by 0.932 mmol/L. Evaluation of our data by receiver operating characteristic curve demonstrated 100% sensitivity cutoff at 4.1 mmol/L.


CONCLUSIONS
HemoCue cannot be used satisfactorily in the management of glycaemia in the NICU. In the preterm population, birth weight had a dramatic influence on HemoCue accuracy. Low haematocrit and parenteral feeding further contributed to a decrease in the accuracy of this device.
Bellini
Carlo
C
Servizio di Patologia Neonatale, Dipartimento di Scienze Pediatriche, Università di Genova, Istituto G. Gaslini, Genova, Italy. carlobellini@ospedale-gaslini.ge.it
Serra
Giovanni
G
Risso
Domenico
D
Mazzella
Massimo
M
Bonioli
Eugenio
E
D001786:Blood Glucose / Q000032:analysis*; D019963:Clinical Chemistry Tests / Q000295:instrumentation*; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D019095:Point-of-Care Systems; D015203:Reproducibility of Results
D001786:Blood Glucose