Dias Moreira Ana Sofia, Weng Hsin-Yi, Hostnik Laura D, Beasley Erin M, Peek Simon F, Munsterman Amelia S
Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, Michigan, USA.
Department of Comparative Pathobiology, Purdue University, West Lafayette, Indiana, USA.
J Vet Emerg Crit Care (San Antonio). 2024 Nov-Dec;34(6):570-578. doi: 10.1111/vec.13429. Epub 2024 Nov 18.
To compare glucose measurements from capillary and venous blood samples using a point-of-care (POC) glucometer with a standard laboratory (colorimetric, glucose oxidase) assay (LABGLU) in a population of hospitalized, neonatal foals.
Multicenter, prospective, experimental study, conducted between March 2019 and June 2020.
Four university teaching hospitals and 1 private referral hospital.
Fifty-four hospitalized neonatal (≤30 days of age) foals.
Simultaneous capillary (muzzle, POCMUZ) and venous (jugular, POCJUG) blood samples were obtained to determine POC glucose concentrations. Venous samples were also analyzed by LABGLU. Each foal was sampled at the time of enrollment or admission to the hospital and at 1 subsequent point during hospitalization. Indirect mean arterial pressure and hematocrit were concurrently recorded.
Bland-Altman analysis showed a mean bias (95% limits of agreement) of -28.0 (-88.6 to 32.6) mg/dL for comparison of POCJUG with LABGLU, -8.2 (-94.3 to 78.0) mg/dL for POCMUZ and LABGLU, and 18.8 (-44.4 to 82.0) mg/dL for POCMUZ and POCJUG. A total of 63.5% of the POCJUG and 45.2% of the POCMUZ samples exceeded the reference value by ±15 mg/dL (for LABGLU samples <75 mg/dL) or ±15% (for LABGLU samples ≥75mg/dL). Concordance correlation coefficient (95% confidence interval [CI]) indicated a fair agreement between POCJUG and LABGLU (0.75, 95% CI: 0.66-0.82) and between POCMUZ and LABGLU (0.71, 95% CI: 0.58-0.80). Fifty percent (14/28) of hypoglycemic foals on the reference method were incorrectly classified as euglycemic by POCJUG, and 5 of 28 were incorrectly classified by POCMUZ.
In the sampled population, the chosen POC glucometer lacked agreement with the standard laboratory measurement. Limits of agreement were wide for both POCJUG and POCMUZ. Inaccuracies in POC results could impact decision-making in the clinical management of glycemic control in hospitalized neonatal foals and, importantly, increase the risk of hypoglycemic events being underdiagnosed in critical patients.
在一群住院新生驹中，使用即时检测（POC）血糖仪与标准实验室（比色法、葡萄糖氧化酶法）检测（LABGLU）对比毛细血管血样和静脉血样的葡萄糖测量值。
2019年3月至2020年6月期间进行的多中心、前瞻性、实验性研究。
四家大学教学医院和一家私立转诊医院。
54匹住院新生驹（≤30日龄）。
同时采集毛细血管血样（口鼻部，POCMUZ）和静脉血样（颈静脉，POCJUG）以测定POC葡萄糖浓度。静脉血样也通过LABGLU进行分析。每匹驹在入院时或住院期间随后的一个时间点进行采样。同时记录间接平均动脉压和血细胞比容。
Bland-Altman分析显示，POCJUG与LABGLU比较的平均偏差（95%一致性界限）为-28.0（-88.6至32.6）mg/dL，POCMUZ与LABGLU比较为-8.2（-94.3至78.0）mg/dL，POCMUZ与POCJUG比较为18.8（-44.4至82.0）mg/dL。共有63.5%的POCJUG样本和45.2%的POCMUZ样本超出参考值±15mg/dL（LABGLU样本＜＜75mg/dL时）或±15%（LABGLU样本≥75mg/dL时）。一致性相关系数（95%置信区间[CI]）表明POCJUG与LABGLU之间（0.75，95%CI：0.66 - 0.82）以及POCMUZ与LABGLU之间（0.71，95%CI：0.58 - 0.80）一致性尚可。参考方法诊断为低血糖的驹中,50%（14/28）被POCJUG错误分类为血糖正常，28匹中有5匹被POCMUZ错误分类。
在抽样群体中，所选用的POC血糖仪与标准实验室测量结果不一致。POCJUG和POCMUZ的一致性界限都很宽。POC结果的不准确可能会影响住院新生驹血糖控制临床管理中的决策，重要的是，增加了危重症患者低血糖事件漏诊的风险。
