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Measuring blood glucose in neonatal units: how does hemocue compare?
S A Deshpande1, J N Matthews, M P Platt
1Newcastle Neonatal Service, Leazes Wing, Royal Victoria Infirmary, Road, Newcastle upon Tyne.
Archives of Disease in Childhood. Fetal and Neonatal Edition
|November 1, 1996
Summary
Accurate blood glucose monitoring is vital for newborns. The HemoCue system shows promise for bedside testing, offering a compromise between convenience and laboratory accuracy, despite discrepancies with other methods.
Area of Science:
- Neonatal medicine
- Clinical chemistry
- Medical diagnostics
Background:
- Accurate blood glucose measurement is critical for preventing neurodevelopmental issues in neonates.
- Current reagent strip methods, while convenient, lack reliability for neonatal glucose monitoring.
- Established laboratory methods and newer point-of-care devices require evaluation for neonatal use.
Purpose of the Study:
- To evaluate the accuracy and concordance of the HemoCue B-Glucose system against established laboratory methods for neonatal blood glucose determination.
- To compare whole blood glucose measurements from HemoCue, Yellow Springs Instrument (YSI), and hexokinase methods.
- To assess the agreement between HemoCue, YSI, hexokinase, and plasma glucose measurements on Kodak Ektachem.
Main Methods:
- Comparison of four glucose measurement methods: HemoCue B-Glucose (portable), YSI (whole blood), hexokinase (whole blood on Cobas Bio), and Kodak Ektachem (plasma).
- Evaluation of accuracy and concordance using statistical analysis, including limits of agreement.
- Estimation of discordant classification probabilities for hypoglycemia or normoglycemia between methods.
Main Results:
- Substantial discrepancies and wide limits of agreement were observed among the four glucose measurement methods.
- Glucose concentration differences ranged from -29% to +61% (HemoCue vs. YSI) and -36% to +65% (HemoCue vs. Ektachem plasma).
- Probabilities of discordant classification (hypo- or normoglycemia) were relatively low (6.5–7.1%) between HemoCue and other analyzers.
Conclusions:
- Even established laboratory methods for blood glucose determination cannot be used interchangeably in neonates.
- The HemoCue system demonstrates low probabilities of discordant classification, suggesting it may be a suitable compromise for bedside glucose testing.
- The HemoCue system offers a practical balance between near-patient testing convenience and laboratory-level accuracy for neonatal glucose monitoring.