Point-of-care glucose measurement systems should be used with great caution in critically ill intensive care unit patients.

摘要

Meynaar et al assessed the accuracy of the AccuChek point-of-care glucose measurement system in the intensive care unit (ICU) setting (1). The authors conclude that the AccuChek glucose measurement in whole blood with a correction factor has acceptable accuracy for use in ICU patients. We recently demonstrated that the AccuChek (using plasma referenced test strips) failed the International Organization for Standardization (ISO) criteria in our study in >13% of samples (2). The ICU population that was studied by Meynaar et al had lower Acute Physiology and Chronic Health Evaluation II scores on hospital admission compared to our study (17.8 +- 6.7 vs. 21.0 [16-25]) and included a higher number of surgical patients (47% vs. 16%). Because patients with inaccurate glucose values had a higher disease severity score and mortality, the discrepancy between the results found by Meynaar and our study group may be related to the less severely ill study population. This is supported by the fact that in the same study the AccuChek was highly accurate in non-ICU patients (2.5% inaccurate samples according to ISO standards). Because we found different accuracy levels for the same test device between different populations, it is seems likely that the confounding factor is patient related.