Tight glucose control in the intensive care unit: are glucose meters up to the task?

Typical TGC protocols consist of placing postoperative and critically ill patients on a continuous intravenous insulin infusion, checking their blood glucose concentrations on an hourly basis (or other schedule), and giving a bolus of insulin and/or changing the infusion rate of insulin based on the...

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Bibliographic Details
Published in:Clinical chemistry (Baltimore, Md.) Md.), 2009-01, Vol.55 (1), p.18-20
Main Authors: Scott, Mitchell G, Bruns, David E, Boyd, James C, Sacks, David B
Format: Article
Language:English
Subjects:
Blood Chemical Analysis - instrumentation
Blood Chemical Analysis - standards
Blood Glucose - analysis
Blood Glucose - metabolism
Clinical Protocols
Diabetes
Glucose
Glycemic Index
Humans
Insulin
Intensive care
Intensive Care Units
Laboratory methods
Meta-analysis
Methods
Mortality
Studies
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Summary:Typical TGC protocols consist of placing postoperative and critically ill patients on a continuous intravenous insulin infusion, checking their blood glucose concentrations on an hourly basis (or other schedule), and giving a bolus of insulin and/or changing the infusion rate of insulin based on the glucose concentration, with a goal of maintaining glucose between 4.4 and 6.7 mmol/L (80 and 120 mg/dL). Because of the total dependence of treatment decisions in these protocols (and most likely of outcomes) on patient glucose values, we believe it to be important that future glucose meters used in these protocols have decreased total error and be subject to the same regulatory requirements as central laboratory methods.
ISSN:0009-9147
1530-8561
DOI:10.1373/clinchem.2008.117291