Accuracy of Point-of-Care Blood Glucose Meters Compared With Central Laboratory Reference Methods in Critically Ill AdultsA Systematic Review
##doi.readerDisplayName##:
https://doi.org/10.65166/88wy1c14关键词:
point-of-care testing, blood glucose, glucometer, intensive care, analytical accuracy, bias, ISO 15197, QUADAS-2, systematic review摘要
Background: Point-of-care (POC) blood glucose meters shorten turnaround time for bedside glycemic management, but critical illness introduces physiologic and analytical conditions that can degrade agreement with central laboratory measurements. Objective: To synthesize evidence on the analytical and clinical accuracy of POC blood glucose meters versus central laboratory reference methods in critically ill adults and identify conditions associated with disagreement. Methods: Searches of PubMed, Google Scholar, and SciSpace identified 1,003 records published from 2010 through September 13, 2026. After removal of 280 duplicates, 723 unique records remained. An initial screening limit left 223 deduplicated records without title/abstract assessment; a subsequent completeness audit applied the same eligibility criteria to these records and re-evaluated full-text decisions. Thirty studies were included. Risk of bias was assessed with an adapted QUADAS-2 framework. Results: POC performance was strongly device-, specimen-, and context-dependent. Several modern systems showed small average bias and high standards compliance in selected ICU cohorts, whereas capillary measurements deteriorated substantially in shock, hypotension, catecholamine/vasopressor exposure, anemia or hematocrit extremes, acidemia, hypoglycemia, and selected drug/interference states. Reported ISO compliance ranged from very high in stable or validated device-specific conditions to markedly poor in shock subgroups; these percentages were not directly pooled because studies used different devices, specimens, standards, thresholds, and outcome metrics. Conclusion: POC glucose meters cannot be treated as analytically interchangeable with central laboratory testing across all critically ill adults. Risk-stratified confirmation with laboratory testing is warranted when POC results are clinically discordant or obtained under physiologic conditions known to impair meter performance.
##plugins.themes.default.displayStats.downloads##
参考
Alshaer, A., Badgheish, B. A., Alsadah, Z., Sewify, K., Alghazal, S., Alzahrani, S. A., Qadi, A. A., Alqahtani, R., Farsani, G. A., & Shilash, A. (2022). Comparing the accuracy of point-of-care with laboratory (capillary, venous, and arterial) blood glucose levels in critically ill patients with and without shock. BMC Research Notes. https://doi.org/10.1186/s13104-022-06256-0
Argollo, A. P. B., Faustino, T. N., Faustino, T. N., & Pedreira, L. C. (2010). Valores glicêmicos oferecidos pelo glicosímetro portátil, utilizando sangue de diferentes vias de coleta: Estudo de validade. Revista Brasileira de Terapia Intensiva. https://doi.org/10.1590/s0103-507x2010000400007
Bhurayanontachai, R. (2016). Agreement of blood glucose levels between venous blood test and arterial blood glucometer in the ICU. Netherlands Journal of Critical Care.
Claerhout, H., De Prins, M., Mesotten, D., Van den Berghe, G., Mathieu, C., Van Eldere, J., & Vanstapel, F. (2016). Performance of strip-based glucose meters and cassette-based blood gas analyzer for monitoring glucose levels in a surgical intensive care setting. Clinical Chemistry and Laboratory Medicine. https://doi.org/10.1515/cclm-2014-1289
Corl, D. E., Yin, T. S., Mills, M. E., Spencer, T. L., Greenfield, L., Beauchemin, E., Cochran, J., Suhr, L. D., Thompson, R. E., & Wisse, B. E. (2013). Evaluation of point-of-care blood glucose measurements in patients with diabetic ketoacidosis or hyperglycemic hyperosmolar syndrome admitted to a critical care unit. Journal of Diabetes Science and Technology. https://doi.org/10.1177/193229681300700516
Creed, G. M., Fox, T. J., & Beale, R. (2011). Point-of-care glucose monitoring in a critical care setting: Evaluation of a new maltose independent chemistry Accu-Chek INFORM II, Nova StatStrip, and Abbott Medisense PXP. Point of Care: The Journal of Near-Patient Testing & Technology. https://doi.org/10.1097/poc.0b013e318207813b
DuBois, J. A., Slingerland, R. J., Fokkert, M. J., Roman, A., Tran, N. K., Clarke, W., Sartori, D. A., Palmieri, T. L., Malic, A., Lyon, M. E., & Lyon, A. W. (2017). Bedside glucose monitoring—is it safe? A new, regulatory-compliant risk assessment evaluation protocol in critically ill patient care settings. Critical Care Medicine. https://doi.org/10.1097/ccm.0000000000002252
DuBose, J. J., Inaba, K., Branco, B. C., Barmparas, G., Lam, L., Teixeira, P. G. R., Belzberg, H., & Demetriades, D. (2012). Discrepancies between capillary glucose measurements and traditional laboratory assessments in both shock and non-shock states after trauma. Journal of Surgical Research. https://doi.org/10.1016/j.jss.2012.04.003
Ellis, M. F., Benjamin, K., Cornell, M., Decker, K., Farrell, D., McGugan, L., Porter, G. P., Shearin, H., Zhao, Y., & Granger, B. B. (2013). Suitability of capillary blood glucose analysis in patients receiving vasopressors. American Journal of Critical Care. https://doi.org/10.4037/ajcc2013692
Fekih Hassen, M., Ayed, S., Gharbi, R., Ben Sik Ali, H., Marghli, S., & Elatrous, S. (2010). Bedside capillary blood glucose measurements in critically ill patients: Influence of catecholamine therapy. Diabetes Research and Clinical Practice. https://doi.org/10.1016/j.diabres.2009.09.018
Feng, T., & Cao, X.-Y. (2012). Evaluation of accuracy and influence factors of bedside blood glucose monitoring in critically ill patients. Chinese Critical Care Medicine. https://doi.org/10.3760/cma.j.issn.1003-0603.2012.08.010
Garingarao, C. J. P., Buenaluz-Sedurante, M., & Jimeno, C. (2014). Accuracy of point-of-care blood glucose measurements in critically ill patients in shock. Journal of Diabetes Science and Technology. https://doi.org/10.1177/1932296814538608
Gijzen, K., Moolenaar, D. L. J., Weusten, J. J. A. M., Pluim, H. J., & Demir, A. Y. (2012). Is there a suitable point-of-care glucose meter for tight glycemic control? Evaluation of one home-use and four hospital-use meters in an intensive care unit. Clinical Chemistry and Laboratory Medicine. https://doi.org/10.1515/cclm-2012-0104
Hopf, S., Graf, B. M., & Gruber, M. (2011). Comparison of point-of-care testing glucose results from intensive care patients measured with network-ready devices. Diabetes Technology & Therapeutics. https://doi.org/10.1089/dia.2011.0051
International Organization for Standardization. (2013). ISO 15197:2013: In vitro diagnostic test systems—Requirements for blood-glucose monitoring systems for self-testing in managing diabetes mellitus.
Karon, B. S., Blanshan, C. T., Deobald, G. R., & Wockenfus, A. M. (2014). Retrospective evaluation of the accuracy of Roche AccuChek Inform and Nova StatStrip glucose meters when used on critically ill patients. Diabetes Technology & Therapeutics. https://doi.org/10.1089/dia.2014.0074
Lonjaret, L., Claverie, V., Bérard, E., Riu-Poulenc, B., Geeraerts, T., Genestal, M., & Fourcade, O. (2012). Relative accuracy of arterial and capillary glucose meter measurements in critically ill patients. Diabetes & Metabolism. https://doi.org/10.1016/j.diabet.2011.12.003
López, M., Serrano, J. L., Robles Rodríguez, J. L., & Márquez Márquez, T. (2012). Validation of a glucose meter at an intensive care unit. Endocrinología y Nutrición: Órgano de la Sociedad Española de Endocrinología y Nutrición. https://doi.org/10.1016/j.endoen.2011.08.003
Louie, R. F., Curtis, C. M., Toffaletti, J. G., Handel, E. A., Slingerland, R. J., Fokkert, M. J., Muller, W., Weinert, S. E., Lee, D. M., & Kotagiri, S. (2015). Performance evaluation of a glucose monitoring system for point-of-care testing with the critically ill patient population—A multicenter study. Point of Care: The Journal of Near-Patient Testing & Technology. https://doi.org/10.1097/poc.0000000000000045
Mahmoodpoor, A., Hamishehkar, H., Shadvar, K., Sanaie, S., Iranpour, A., & Fattahi, V. (2016). Validity of bedside blood glucose measurement in critically ill patients with intensive insulin therapy. Indian Journal of Critical Care Medicine. https://doi.org/10.4103/0972-5229.194009
Mishra, K., Mishra, S., & Katial, T. (2024). Accuracy of point-of-care capillary blood sugar measurements in critically ill patients: An observational study. International Journal of Critical Illness and Injury Science. https://doi.org/10.4103/ijciis.ijciis_76_23
Mitsios, J. V., Ashby, L., Haverstick, D. M., Bruns, D. E., & Scott, M. G. (2013). Analytic evaluation of a new glucose meter system in 15 different critical care settings. Journal of Diabetes Science and Technology. https://doi.org/10.1177/193229681300700518
Page, M. J., McKenzie, J. E., Bossuyt, P. M., et al. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
Pereira, A. J., Corrêa, T. D., Pereira de Almeida, F., Deliberato, R. O., dos Santos Lobato, M., Akamine, N., Silva, E., & Cavalcanti, A. B. (2015). Inaccuracy of venous point-of-care glucose measurements in critically ill patients: A cross-sectional study. PLOS ONE. https://doi.org/10.1371/journal.pone.0129568
Pidcoke, H. F., Wade, C. E., Mann, E. A., Salinas, J., Cohee, B. M., Holcomb, J. B., & Wolf, S. E. (2010). Anemia causes hypoglycemia in intensive care unit patients due to error in single-channel glucometers: Methods of reducing patient risk. Critical Care Medicine. https://doi.org/10.1097/ccm.0b013e3181bc826f
Pilackas, K., El-Oshar, S., & Carter, C. (2020). Clinical reliability of point-of-care glucose testing in critically ill patients. Journal of Diabetes Science and Technology. https://doi.org/10.1177/1932296819858633
Rosengrave, P. C., Wohlrab, C., Spencer, E., Williman, J., Shaw, G., & Carr, A. C. (2022). Effect of intravenous vitamin C on arterial blood gas analyser and Accu-Chek point-of-care glucose monitoring in critically ill patients. Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine. https://doi.org/10.51893/2022.2.oa7
Schmolze, D., Horowitz, G. L., & Tolan, N. V. (2016). Using point of care glucose meters in the critically ill: Assessing meter performance in the clinical context. Point of Care: The Journal of Near-Patient Testing & Technology. https://doi.org/10.1097/poc.0000000000000107
Schroeder, L. F., Giacherio, D., Gianchandani, R., Engoren, M., & Shah, N. H. (2016). Postmarket surveillance of point-of-care glucose meters through analysis of electronic medical records. Clinical Chemistry. https://doi.org/10.1373/clinchem.2015.251827
Sheen, Y. J., Wang, J.-M., Tsai, P.-F., Lee, W.-J., Hsu, Y.-C., Wang, C.-Y., & Sheu, W. H.-H. (2023). Accuracy of point-of-care blood glucometers in neonates and critically ill adults. Clinical Therapeutics. https://doi.org/10.1016/j.clinthera.2023.05.005
Smith, K., Brown, C. S., Manning, B. M., May, T., Riker, R. R., Lerwick, P., Hayes, T. L., & Fraser, G. L. (2018). Accuracy of point-of-care blood glucose level measurements in critically ill patients with sepsis receiving high-dose intravenous vitamin C. Pharmacotherapy. https://doi.org/10.1002/phar.2182
Whiting, P. F., Rutjes, A. W. S., Westwood, M. E., et al. (2011). QUADAS-2: A revised tool for the quality assessment of diagnostic accuracy studies. Annals of Internal Medicine, 155(8), 529–536. https://doi.org/10.7326/0003-4819-155-8-201110180-00009
Zhang, R., Isakow, W., Kollef, M. H., & Scott, M. G. (2017). Performance of a modern glucose meter in ICU and general hospital inpatients: 3 years of real-world paired meter and central laboratory results. Critical Care Medicine. https://doi.org/10.1097/ccm.0000000000002572
##submission.downloads##
已出版
##submission.license##
##submission.copyrightStatement##
##submission.license.cc.by-nc-sa4.footer##This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors retain copyright of their articles but grant the International Journal of Health & Business Analytics (IJHBA) the right of first publication.
