title: Performance of cassette-based blood gas analyzers to monitor blood glucose and lactate levels in a surgical intensive care setting.
abstract: BACKGROUND
  With the use of a traditional blood gas analyzer (BGA) (ABL800 Radiometer) for blood glucose monitoring, tight glucose control (TGC) reduced in-hospital mortality and morbidity of surgical intensive care unit (ICU) adult and pediatric patients. Such BGAs are now superseded by cassette-based BGAs. We assessed the analytical reliability of cassette-based BGAs to monitor patient's metabolic status in an ICU setting.
  
  
  METHODS
  We evaluated recovery/linearity, imprecision/repeatability and relative accuracy vs. comparison methods for glucose [coupled hexokinase glucose-6-phosphate dehydrogenase (HK/G6PD) assay] and lactate (lactate dehydrogenase assay) in ICU patient samples with two cassette-based BGAs [RP500 (Siemens) and ABL90 (Radiometer)] and with the ABL800 BGA.
  
  
  RESULTS
  Recovery of spiked glucose up to 348 mg/dL (19.3 mmol/L) was complete for all BGAs. Repeatability of ABL800 and ABL90 was comparable with the comparison method (about 1%), but higher for RP500 (about 2.4%). All BGAs were in agreement with the comparison method, with all glucose measurements falling within preset 10% criteria suggested by Karon. Recovery of spiked lactate (up to 25 mmol/L) was incomplete at all levels. Repeatability of ABL800 and ABL90 was comparable with the comparison method (about 4%), and 5.5% for RP500. All BGAs were in agreement with the comparison method, with >98% of the lactate measurements falling within 30% biological-variation-based criteria.
  
  
  CONCLUSIONS
  The cassette-based BGAs quantified blood glucose and lactate levels in ICU patients within the acceptable error ranges. Cassette-based BGAs can be used for monitoring patient's metabolic status in an ICU setting.
authors.affiliation: Laboratory Medicine, UZ Leuven, Leuven, Belgium.
authors.forename: Koen
authors.initials: K
authors.lastname: Poesen
authors.forename: Martine
authors.initials: M
authors.lastname: De Prins
authors.forename: Greet
authors.initials: G
authors.lastname: Van den Berghe
authors.forename: Johan
authors.initials: J
authors.lastname: Van Eldere
authors.forename: Florent
authors.initials: F
authors.lastname: Vanstapel
mesh_terms: D000328:Adult; D001784:Blood Gas Analysis / Q000592:standards*; D001786:Blood Glucose / Q000032:analysis*; D002138:Calibration; D002648:Child; D003422:Critical Care; D006801:Humans; D007362:Intensive Care Units; D019344:Lactic Acid / Q000097:blood*; D008991:Monitoring, Physiologic / Q000592:standards; D019095:Point-of-Care Systems / Q000592:standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D001786:Blood Glucose; D019344:Lactic Acid