Intensive Care Unit, CHU Taher Sfar, Mahdia 5100, Tunisia.
Diabetes Res Clin Pract. 2010 Jan;87(1):87-91. doi: 10.1016/j.diabres.2009.09.018. Epub 2009 Oct 23.
To evaluate the effects of catecholamine therapy on the accuracy of capillary glucose measurements in hyperglycemic patients.
43 hyperglycemic patients older than 18 years admitted to the intensive care unit of a tertiary medical center were included from December 2005 to March 2006.
This prospective study compares fingerstick and earlobe measurements simultaneously to sampled laboratory venous glucose in patients treated without (group 1) or with (group 2) catecholamine. Three venous samples for serum glucose analysis at three fixed hours and simultaneously two capillary glucose determinations were performed during the two first successive days after inclusion. A difference between the methods of glucose measurements greater than 2.3 mmol/l was considered significant.
The mean difference between the two methods was -0.05 mmol/l in group 1 and +0.29 mmol/l in group 2, while the limits of agreement were +4.03 and -4.13 mmol/l and +5.63 and -5.05 mmol/l in groups 1 and 2, respectively. A difference between paired measurements greater than 2.3 mmol/l was observed in 29% in group 1 and in 40% in group 2 (p=0.038). The alternative site did not improve the accuracy.
In critically ill patients treated with catecholamine capillary fingerstick blood glucose measurement seems inaccurate. Earlobe sampling does not improve accuracy.
评估儿茶酚胺治疗对高血糖患者毛细血管血糖测量准确性的影响。
2005 年 12 月至 2006 年 3 月期间，共有 43 名年龄大于 18 岁的入住三级医疗中心重症监护病房的高血糖患者入选。
本前瞻性研究比较了未接受儿茶酚胺治疗（第 1 组）和接受儿茶酚胺治疗（第 2 组）的患者同时进行的指血和耳血测量与实验室静脉血糖采样的结果。在入选后的前两天内，每天固定三个时间采集三个静脉血样本进行血清葡萄糖分析，并同时进行两次毛细血管血糖测定。如果两种方法测量的血糖值差异大于 2.3mmol/L，则认为差异具有统计学意义。
第 1 组两种方法的平均差值为-0.05mmol/L，第 2 组为+0.29mmol/L，而第 1 组和第 2 组的一致性界限分别为+4.03 和-4.13mmol/L和+5.63 和-5.05mmol/L。第 1 组中有 29%的配对测量值差异大于 2.3mmol/L，第 2 组中有 40%（p=0.038）。替代部位采样并不能提高准确性。
在接受儿茶酚胺治疗的危重症患者中，毛细血管指血血糖测量似乎不准确。耳血采样并不能提高准确性。
