title: Validity of bedside blood glucose measurement in critically ill patients with intensive insulin therapy.
abstract: OBJECTIVE
  There have been variable results on the practice of tight glycemic control, and studies have demonstrated that point-of-care (POC) glucometers have variable accuracy. Glucometers must be accurate, and many variables can affect blood glucose levels. The purpose of this study was to determine the difference between blood glucose concentrations obtained from POC glucometers and laboratory results in critically ill patients with intensive insulin therapy.
  
  
  METHODS
  This was a descriptive study which enrolled 300 critically ill patients. Four samples of arterial blood were collected and analyzed at the bedside with the POC glucometer and also in the central laboratory to obtain the blood glucose level. To define the effect of various factors on this relation, we noted the levels of hemoglobin (Hb), PaO2, body temperature, bilirubin, history of drug usage, and sepsis.
  
  
  RESULTS
  There were not any significant differences between blood sugar levels using laboratory and glucometer methods of measurements. There was a good and significant correlation between glucose levels between two methods (r= 0.81,P< 0.001). Among evaluated factors (body temperature, bilirubin level, blood pressure, Hb level, PaO2, sepsis, and drugs) which added one by one in model, just drugs decreased the correlation more than others (r= 0.78).
  
  
  CONCLUSIONS
  The results of POC glucometer differ from laboratory glucose concentrations, especially in critically ill patients with unstable hemodynamic status while receiving several drugs. This may raise the concern about using POC devices for tight glycemic control in critically ill patients. These results should be interpreted with caution because of the large variation of accuracy among different glucometer devices.
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Ata
authors.initials: A
authors.lastname: Mahmoodpoor
authors.affiliation: Department of Clinical Pharmacy, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Hadi
authors.initials: H
authors.lastname: Hamishehkar
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Kamran
authors.initials: K
authors.lastname: Shadvar
authors.affiliation: Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Sarvin
authors.initials: S
authors.lastname: Sanaie
authors.affiliation: Department of Anesthesiology, Al Garhoud Private Hospital, Dubai, UAE.
authors.forename: Afshin
authors.initials: A
authors.lastname: Iranpour
authors.affiliation: Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Vahid
authors.initials: V
authors.lastname: Fattahi
keywords: Glucometer; Intensive Care Unit; insulin therapy; laboratory; validity