Inaccuracy of venous point-of-care glucose measurements in critically ill patients: a cross-sectional study

Introduction: Current guidelines and consensus recommend arterial and venous samples as equally acceptable for blood glucose assessment in point-of-care devices, but there is limited evidence to support this recommendation. We evaluated the accuracy of two devices for bedside point-of-care blood glucose measurements using arterial, fingerstick and catheter venous blood samples in ICU patients, and assessed which factors could impair their accuracy. Methods: 145 patients from a 41-bed adult mixed-ICU, in a tertiary care hospital were prospectively enrolled. Fingerstick, central venous (catheter) and arterial blood (indwelling catheter) samples were simultaneously collected, once per patient. Arterial measurements obtained with Precision PCx, and arterial, fingerstick and venous measurements obtained with Accu-chek Advantage II were compared to arterial central lab measurements. Agreement between point-of-care and laboratory measurements were evaluated with Bland-Altman, and multiple line...引言：当前指南与共识均推荐动脉血与静脉血样本同等适用于床旁检测（point-of-care）设备的血糖测定，但支持该推荐的相关证据尚有限。本研究针对重症监护病房（ICU）患者，采用动脉血、指尖采血及导管静脉血样本，评估两款床旁血糖检测设备的检测准确性，并分析可能影响其检测准确性的相关因素。 方法：本研究前瞻性纳入某三级医院41张床位的成人综合ICU的145例患者。每位患者同步采集指尖血、中心静脉（导管）血及动脉（留置导管）血样本各一次。以中心实验室动脉血检测结果为金标准，分别对比Precision PCx设备的动脉血检测结果，以及Accu-chek Advantage II设备的动脉血、指尖血与静脉血检测结果。采用Bland-Altman分析法评估床旁检测与实验室检测结果的一致性，并开展多因素...（原文未完整）