Monitorización de la glucemia en cuidados intensivos. Resultados de una encuesta

Moral-Martín, Raimundo García del; Cobos‐Vargas, Angel; Rodriguez-Delgado, Esther; Colmenero, Manuel

doi:10.1016/j.medin.2020.09.006

Cited by 3 publications

(3 citation statements)

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“…7 While it is true that the recommendation is based on the best practice available, the result of a recent survey has shown that capillary blood glucose determination is still used in our ICUs. 16 The results of this survey are representative of the overall ICU for two reasons: the high percentage of respondents (87% of the total)…”

Section: Discussionmentioning

confidence: 97%

“…The international conference “Surviving Sepsis Campaign” establishes the recommendation to use arterial blood samples for glucometer measurements, although with a weak grade of recommendation with low‐quality of evidence 7 . While it is true that the recommendation is based on the best practice available, the result of a recent survey has shown that capillary blood glucose determination is still used in our ICUs 16 . The results of this survey are representative of the overall ICU for two reasons: the high percentage of respondents (87% of the total) and their distribution (polyvalent and specialized ICUs of first, second, and third‐level hospitals).…”

Section: Discussionmentioning

confidence: 99%

“…Despite these recommendations arterial, capillary, and central venous blood samples are interchangeably used in intensive care units 16 . There are several reasons why capillary or venous blood are still used: its simplicity and quick availability, to avoid blood that is discarded, and when there is no need for blood gas analysis.…”

Section: Introductionmentioning

confidence: 99%

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Agreement of blood glucose measured with glucose meter in arterial, central venous, and capillary samples in adult critically ill patients

Rodriguez-Delgado

Moral

Cobos‐Vargas

et al. 2021

Nursing in Critical Care

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Background: The measurement of blood glucose in critically ill patients is still performed in many ICUs with glucose meters and capillary samples. Several prevalent factors in these patients affect the accuracy of the results and should be interpreted with caution. A weak recommendation from the Surviving Sepsis Campaign (SSC) suggests the use of arterial blood rather than capillary blood for point of care testing using glucose meters. Aims and objectives: To analyse the agreement between arterial, central venous, and capillary blood samples of glucose values measured by glucose meter in critically ill patients and study potential confounding factors. Design: Prospective cross-sectional study in a general intensive care unit (ICU). Patients needing insulin treatment (subcutaneous or intravenous) and blood glucose control were included. Methods: Standardized collection of blood samples and measurement of glucose values with a glucometer. Agreement was studied by the Bland-Altman method and stratified analysis of disagreement-survival plots was used to study the influence of haematocrit, pH range, SOFA score, capillary refilling time, intravenous insulin infusion, and lactic acid.Results: A total of 297 measurements from 54 patients were included. The mean arterial blood glucose was 150.42 (range 31-345 mg/dL). In the graphical analysis, there is a poor agreement both in capillary and venous central to arterial samples, but in opposite direction (underestimation of capillary and overestimation of central venous). Factors associated with a reduction in the agreement between arterial and capillary samples were elevated lactate, poor capillary refilling, and hemodynamic failure. Patients without hemodynamic compromise have an acceptable agreement with values for absolute differences of 16 mg/dL for a disagreement of 10%. Conclusions:In critically ill patients, the measurement of blood glucose with a glucose meter should be performed with arterial samples whenever possible. Capillary samples do not accurately estimate arterial blood glucose values in patients with

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%