In general, laboratory methods are more accurate and so far, only one blood glucose POCT meter has been shown to produce equivalent results to a laboratory method. We therefore focus on arterial measurements in this study. Arterial measurements are less disturbed by skin temperature and peripheral circulation. Controlled capillary measurements depend on a lot of different factors which are not constant during general anesthesia. This can also affect capillary blood sampling, which may result in a lower glucose concentration. Furthermore, fluid shifts during surgery are common due to blood loss, fluid administrations, and vasodilatory effect of anesthetics. General anesthesia often induces hypotension, which can cause reduction of perfusion and thereby a reduction of blood refreshing, leading to less accurate capillary blood glucose measurement compared to the actual value in the systemic circulation. BG concentrations can be measured by several methods, including point-of-care test (POCT) BG meters and laboratory methods. Hypoglycemia and hyperglycemia are unwanted conditions perioperatively, with BG concentrations between 4 and 12 mmol/L recommended by most guidelines. We conclude that POCT measurements conducted on arterial specimens using the ACI II provide sufficiently accurate results for glucose measurement during surgery under general anesthesia.īlood glucose (BG) monitoring in diabetic patients during general anesthesia is important. ConclusionĪrterial BG measurements during surgery in patients with DM under general anesthesia using POCT BG meter are in general lower than laboratory measurements, but the ICC and CCC show a clinically acceptable correlation. In general, the reference method produced higher values than ACI II. The results showed an estimated mean difference of 0.8 mmol/L between ACI II and the reference method, with limits of agreement equal to -0.6 and 2.2 mmol/L. A Bland–Altman plot was used to visualize the differences between both methods, and correlation was assessed using the intra-class correlation coefficient (ICC). One drop of blood was used for Accu Chek Inform II (ACI II) POCT BG meter and the residual blood was sent to the clinical laboratory for a Hexokinase Plasma reference method. Arterial blood samples were taken at least 60 minutes after induction. This cross-sectional study included 75 arterial BG measurements from 75 patients (71 with DM, mostly insulin dependent) who underwent elective non-cardiac surgery under general anesthesia. However, these meters are not validated for patients under general anesthesia. Access to point-of-care test (POCT) glucose meters at an operating room will usually provide monitoring at shorter intervals and may improve glycemic control. Blood glucose (BG) concentrations of patients with diabetes mellitus (DM) are monitored during surgery to prevent hypo- and hyperglycemia.
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