title: Hematocrit correction does not improve glucose monitor accuracy in the assessment of neonatal hypoglycemia.
abstract: BACKGROUND
  The lack of accuracy of point of care (POC) glucose monitors has limited their use in the diagnosis of neonatal hypoglycemia. Hematocrit plays an important role in explaining discordant results. The objective of this study was to to assess the effect of hematocrit on the diagnostic performance of Abbott Precision Xceed Pro (PXP) and Nova StatStrip (StatStrip) monitors in neonates.
  
  
  METHODS
  All blood samples ordered for laboratory glucose measurement were analyzed using the PXP and StatStrip and compared with the laboratory analyzer (ABL 800 Blood Gas analyzer [ABL]). Acceptable error targets were ±15% for glucose monitoring and ±5% for diagnosis.
  
  
  RESULTS
  A total of 307 samples from 176 neonates were analyzed. Overall, 90% of StatStrip and 75% of PXP values met the 15% error limit and 45% of StatStrip and 32% of PXP values met the 5% error limit. At glucose concentrations ≤4 mmol/L, 83% of StatStrip and 79% of PXP values met the 15% error limit, while 37% of StatStrip and 38% of PXP values met the 5% error limit. Hematocrit explained 7.4% of the difference between the PXP and ABL whereas it accounted for only 0.09% of the difference between the StatStrip and ABL. The ROC analysis showed the screening cut point with the best performance for identifying neonatal hypoglycemia was 3.2 mmol/L for StatStrip and 3.3 mmol/L for PXP.
  
  
  CONCLUSIONS
  Despite a negligible hematocrit effect for the StatStrip, it did not achieve recommended error limits. The StatStrip and PXP glucose monitors remain suitable only for neonatal hypoglycemia screening with confirmation required from a laboratory analyzer.
authors: Faculty of HealthSciences, Department of Pathology and Molecular Medicine, McMaster University HSC-2N22B, 1200 Main St. W Hamilton, ON, L8N 3Z5, Canada. li.wang@medportal.ca
authors: Li
authors: L
authors: Wang
authors: John L
authors: JL
authors: Sievenpiper
authors: Russell J
authors: RJ
authors: de Souza
authors: Michele
authors: M
authors: Thomaz
authors: Susan
authors: S
authors: Blatz
authors: Vijaylaxmi
authors: V
authors: Grey
authors: Christoph
authors: C
authors: Fusch
authors: Cynthia
authors: C
authors: Balion
mesh_terms: D001774:Blood Chemical Analysis / Q000295:instrumentation* / Q000379:methods; D001786:Blood Glucose / Q000032:analysis*; D006400:Hematocrit; D006801:Humans; D007003:Hypoglycemia / Q000097:blood* / Q000175:diagnosis; D007231:Infant, Newborn; D019095:Point-of-Care Systems
chemical_list: D001786:Blood Glucose