| Background and Aims: 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. Materials and 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. |