Chenoweth James A, Dang Luke T, Gao Guofeng, Tran Nam K
Division of Medical Toxicology, Department of Emergency Medicine, University of California - Davis School of Medicine, Sacramento, CA, USA.
Department of Pathology and Laboratory Medicine, University of California - Davis School of Medicine, Sacramento, CA, USA.
Clin Toxicol (Phila). 2020 Nov;58(11):1067-1070. doi: 10.1080/15563650.2020.1732404. Epub 2020 Mar 6.
Point-of-care glucose meters are an integral part in the assessment of patients with altered mental status. For this reason, glucose meters are checked for interference from commonly encountered substances, including acetaminophen. The Nova StatStrip glucose meter has previously been reported to be resistant to interference. We report a case of a very high acetaminophen concentration causing interference with this point-of-care glucose meter. A 25-year-old female presented after an overdose of acetaminophen and diphenhydramine combination product. Patient was minimally responsive, so a point-of-care glucose check was attempted using the Nova StatStrip glucose meter. Five different meters were attempted, and each showed an error message. Laboratory analysis using Beckman Coulter Unicel DxC 800 revealed a glucose of 180 mg/dL and an acetaminophen concentration of 465 mg/L. Serum spiked with acetaminophen at different concentrations revealed interference with the Nova StatStrip glucose meter at a concentration of 399 mg/L and above. To our knowledge, this interference with the Nova StatStrip glucose meter has not been reported in the medical literature. Very high levels of acetaminophen can interfere with point-of-care glucose meters, even those that have previously been reported to be robust such as the Nova StatStrip glucose meter. Clinicians should be aware of this possible interference when treating patients with acetaminophen overdose.
即时检测血糖仪是评估精神状态改变患者的重要组成部分。因此，需检测血糖仪是否会受到常见物质（包括对乙酰氨基酚）的干扰。此前有报道称诺瓦StatStrip血糖仪具有抗干扰能力。我们报告了一例因对乙酰氨基酚浓度极高而导致该即时检测血糖仪出现干扰的病例。一名25岁女性在过量服用对乙酰氨基酚和苯海拉明复方制剂后就诊。患者反应极弱，因此尝试使用诺瓦StatStrip血糖仪进行即时血糖检测。尝试了五种不同的血糖仪，每一种都显示错误信息。使用贝克曼库尔特Unicel DxC 800进行实验室分析显示血糖为180mg/dL，对乙酰氨基酚浓度为465mg/L。用不同浓度对乙酰氨基酚加样的血清显示，当浓度达到399mg/L及以上时，诺瓦StatStrip血糖仪会受到干扰。据我们所知，医学文献中尚未报道过诺瓦StatStrip血糖仪受到这种干扰的情况。极高水平的对乙酰氨基酚会干扰即时检测血糖仪，即使是那些此前被报道抗干扰能力较强的血糖仪，如诺瓦StatStrip血糖仪。临床医生在治疗对乙酰氨基酚过量的患者时应意识到这种可能的干扰。
