Comparative analysis of four methods for rapid glucose determination in neonates

As an important aspect of newborn care, the rapid assessment of glucose homeostasis is often accomplished by a glucose oxidase-peroxidase chromagen test strip method, either alone or with a reflectance colorimeter. The precision of these techniques has been established, but few studies have determined accuracy in an intensive care setting. We performed the following study. During the time of routine heelstick blood sampling, the nurses collected 90 complete study sets for glucose analysis from 43 neonates. Dextrostix, Ames Meter, Chemstrip bG, and Stat Tek Meter determinations were performed according to manufacturers' instructions. Concurrent determination of blood glucose level by a glucose analyzer (Beckman) served as a standard for comparison. There was no significant difference in estimation of true blood glucose concentration among the rapid methods tested. The marked variability of results suggests only modest accuracy in estimating whole blood glucose concentration when employed in the routine neonatal clinical setting. These data indicate that the results from rapid blood glucose estimation techniques require confirmation by conventional laboratory methods prior to therapeutic intervention.