Karon Brad S, Gandhi Gunjan Y, Nuttall Gregory A, Bryant Sandra C, Schaff Hartzell V, McMahon M Molly, Santrach Paula J
Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
Am J Clin Pathol. 2007 Jun;127(6):919-26. doi: 10.1309/6RFQCKAAJGKWB8M4.
Intravenous insulin protocols are increasingly common in the intensive care unit to maintain normoglycemia. Little is known about the accuracy of point-of-care glucometers for measuring glucose in this patient population or the impact of sample source (capillary, arterial, or venous whole blood) on the accuracy of glucometer results. We compared capillary, arterial, and venous whole blood glucose values with laboratory plasma glucose values in 20 patients after cardiac surgery. All 4 samples (capillary, arterial, and venous whole blood and laboratory plasma glucose) were analyzed hourly for the first 5 hours during intravenous insulin therapy in the intensive care unit. There were no significant differences between median capillary whole blood (149 mg/dL [8.3 mmol/L]) and laboratory plasma (151 mg/dL [8.4 mmol/L]) glucose levels. The median arterial (161 mg/dL [8.9 mmol/L]) and venous (162 mg/dL [9.0 mmol/L]) whole blood glucose levels were significantly higher than the median laboratory plasma glucose level. Capillary whole blood glucose levels correlate most closely with laboratory plasma glucose levels in patients receiving intensive intravenous insulin therapy after cardiac surgery.
在重症监护病房,静脉注射胰岛素方案越来越普遍,目的是维持血糖正常。对于该患者群体中即时检测血糖仪测量血糖的准确性,或样本来源(毛细血管血、动脉血或静脉全血)对血糖仪结果准确性的影响,人们了解甚少。我们比较了20例心脏手术后患者的毛细血管血、动脉血和静脉全血葡萄糖值与实验室血浆葡萄糖值。在重症监护病房进行静脉胰岛素治疗的前5小时内,每小时对所有4种样本(毛细血管血、动脉血、静脉全血和实验室血浆葡萄糖)进行分析。毛细血管全血中位数葡萄糖水平(149mg/dL [8.3mmol/L])与实验室血浆葡萄糖水平(151mg/dL [8.4mmol/L])之间无显著差异。动脉血(161mg/dL [8.9mmol/L])和静脉血(162mg/dL [9.0mmol/L])全血葡萄糖水平中位数显著高于实验室血浆葡萄糖水平中位数。在心脏手术后接受强化静脉胰岛素治疗的患者中,毛细血管全血葡萄糖水平与实验室血浆葡萄糖水平的相关性最为密切。