Cardiac and Surgical Intensive Care Unit at Oregon Health & Science University, Portland, Oregon 97239, USA.
J Cardiovasc Nurs. 2011 Nov-Dec;26(6):512-8. doi: 10.1097/JCN.0b013e31820a7bf4.
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.
The purpose of this study was to determine the difference between blood glucose concentrations obtained from POC glucometers as compared with laboratory results in cardiothoracic surgery (CTS) patients.
This was a descriptive study on a convenience sample of 46 CTS patients. A single sample of arterial blood was collected and analyzed at the bedside with the POC glucometer and in the laboratory to obtain a serum glucose concentration and hematocrit (Hct). A paired t test was used to compare the mean differences along with Spearman ρ correlation to examine the relationship between difference scores and Hct.
The POC glucose was significantly higher than the laboratory result (t = 8.5, P < .001) with a mean of 12.3 (SD, 9.8) mg/dL. Spearman ρ correlation between the difference scores and Hct was -0.43, P = .003. Using a tercile split, groups with Hct of less than 26% (n = 16) and greater than 29% (n = 15) were identified. The unpaired t test on the mean difference scores of these 2 groups was t = -2.7, P < .01, with an overall mean difference 8.6 mg/dL (95% confidence interval, -15 to -2.2). The mean difference was 16.3 in the low-Hct group and 7.8 in the high-Hct group.
Point-of-care glucometer results differ significantly from laboratory glucose concentrations, with the difference widening as the Hct decreases. This raises the concern about using POC devices to provide tight glycemic control in CTS patients.
严格血糖控制的实践结果存在差异，研究表明即时血糖仪的准确性存在差异。
本研究旨在确定心胸外科 (CTS) 患者的即时血糖仪检测的血糖浓度与实验室结果之间的差异。
这是一项便利样本的描述性研究，纳入了 46 名 CTS 患者。采集单个动脉血样本，在床边使用即时血糖仪和实验室方法分别检测血糖浓度和血细胞比容 (Hct)。采用配对 t 检验比较平均差值，采用 Spearman ρ 相关检验差值与 Hct 的关系。
即时血糖仪的血糖值明显高于实验室结果 (t = 8.5, P <.001)，平均差值为 12.3 (SD, 9.8) mg/dL。差值与 Hct 的 Spearman ρ 相关系数为 -0.43, P =.003。根据 Hct 三分位数将患者分为 Hct<26% (n = 16)和 Hct>29% (n = 15)两组。对这两组的平均差值进行独立样本 t 检验，t = -2.7, P <.01，总体平均差值为 8.6 mg/dL (95%置信区间，-15 至 -2.2)。低 Hct 组的平均差值为 16.3 mg/dL，高 Hct 组的平均差值为 7.8 mg/dL。
即时血糖仪的检测结果与实验室葡萄糖浓度存在显著差异，随着 Hct 的降低，差异增大。这引发了对在 CTS 患者中使用即时血糖仪来实现严格血糖控制的担忧。
