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Related Experiment Videos

Fingerstick glucose determination in shock.

S H Atkin1, A Dasmahapatra, M A Jaker

  • 1Emergency Department, University Hospital, Newark, NJ 07103.

Annals of Internal Medicine
|June 15, 1991
PubMed
Summary

Fingerstick glucose tests are inaccurate in severely hypotensive patients, often misdiagnosing hypoglycemia. Venous glucose testing is a more reliable method for assessing blood sugar in critically ill patients.

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Area of Science:

  • Critical Care Medicine
  • Clinical Chemistry
  • Emergency Medicine

Background:

  • Accurate blood glucose monitoring is crucial for managing critically ill patients.
  • Hypotension can potentially affect the accuracy of point-of-care glucose testing devices.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of fingerstick glucose measurements compared to laboratory values in severely hypotensive patients.

Main Methods:

  • A prospective study compared simultaneous fingerstick, venous reagent strip, and laboratory glucose measurements in 25 hypotensive and 39 normotensive patients.
  • Error-grid analysis was used to assess the clinical significance of glucose measurement discrepancies.

Main Results:

  • Fingerstick glucose measurements were significantly lower in hypotensive patients (67.5% of lab values) compared to normotensive patients (91.8%).

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  • Only 36% of hypotensive patients had fingerstick glucose values within 20% of laboratory values.
  • 32% of hypotensive patients received incorrect hypoglycemia diagnoses, with two actually being hyperglycemic.

    • Conclusions:

    • Fingerstick glucose testing is unreliable in severely hypotensive patients and can lead to clinical management errors.
    • Venous reagent strip glucose testing provides accurate results and is recommended for rapid glucose assessment in critically ill hypotensive patients.