Bedside capillary blood glucose measurements in critically ill patients: influence of catecholamine therapy.
OBJECTIVE
To evaluate the effects of catecholamine therapy on the accuracy of capillary glucose measurements in hyperglycemic patients.


METHODS
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.


METHODS
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 2.3 mmol/l was considered significant.


RESULTS
The mean difference between the two methods was -0.05 mmol/l in group 1 and +0.29 mmol/l in group 2, while the limits of agreement were +4.03 and -4.13 mmol/l and +5.63 and -5.05 mmol/l in groups 1 and 2, respectively. A difference between paired measurements greater than 2.3 mmol/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.
Intensive Care Unit, CHU Taher Sfar, Mahdia 5100, Tunisia.
M
M
Fekih Hassen
S
S
Ayed
R
R
Gharbi
H
H
Ben Sik Ali
S
S
Marghli
S
S
Elatrous
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D002196:Capillaries; D002395:Catecholamines / Q000627:therapeutic use*; D016638:Critical Illness / Q000401:mortality / Q000628:therapy*; D004298:Dopamine / Q000627:therapeutic use; D004431:Ear, External / Q000098:blood supply; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D005385:Fingers / Q000098:blood supply; D006801:Humans; D006943:Hyperglycemia / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000627:therapeutic use; D019095:Point-of-Care Systems; D011446:Prospective Studies; D015203:Reproducibility of Results; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
D001786:Blood Glucose; D002395:Catecholamines; D014662:Vasoconstrictor Agents; D004298:Dopamine; D009638:Norepinephrine; D004837:Epinephrine