Patients on a strict glycemic protocol and at increased risk of hypoglycemic episodes must have their glucose levels measured accurately. This is generally the case in this study’s population, as many of these patients are unable to interact with physicians or nurses, and their hypoglycemia symptoms are not readily available. POCT has a number of advantages over conventional blood glucose testing, including the availability of glucose values to the nurse within two minutes and immediate visibility in the hospital information system. In addition, POCT devices require a negligible volume of blood and the risk of blood spillage from the syringe or the device is minimal [20].
In order to implement a protocol for glucose regulation, it is necessary to measure blood glucose levels rapidly and accurately [21, 22]. The application of these protocols increases the nurse’s burden, hence it must be feasible [12, 13, 23]. This implies that not the most exact equipment, but one that is the most practical and provides reasonably accurate glucose analysis would be chosen for this process. In critically ill patients, however, hypoglycemia is critical, and its warning signals are missing; hence, these devices must also be highly reliable in the low range [14,15,16,17,18,19].
When we compared POCT results with lab analysis of glucose concentrations, we discovered that there is no difference between venous and central glucose, however arterial glucose concentrations differ significantly. In addition, we discovered that the POCT exaggerated the venous and central glucose concentrations, while underestimating the arterial glucose concentration. Petersen J et al. [24] and Boyd et al. [25] and Critchell et al. [19] similarly found that glucose meters overstated blood glucose levels in arterial, central, venous, and capillary samples relative to reference standard concentrations. In a different study conducted by Clarke et al. the authors found that the subcutaneous CGMS was accurate in the euglycemic range [26] and in a study conducted by Goldberg et al. they discovered that the POCT had a pearson correlation coefficient of 0.88 with 98.7% of patients falling within the clinically acceptable zones [27]. In a study conducted by Cook et al. the authors discovered that lab glucose values for blood from catheter in critically ill patients were significantly different from POC values for blood from catheter (P = 0.001) and fingerstick (P = 0.001) [14]. In addition, a second study revealed that the clinical agreement between POCT and laboratory analysis is greater in central blood analysis than arterial blood analysis, and in the case of hypoglycemia, only 26.3% of patients with capillary blood analysis demonstrated clinical agreement [16].
Despite the fact that hypoperfusion during shock is recognized to be a factor in the underestimating of glucose levels with capillary sampling [19, 21, 22], it is not observed to be a significant concern in this investigation. Considering glucose concentrations, for instance, there is no significant difference between shocked and non-shocked patients using POCT or laboratory analysis. This conclusion is comparable to the outcomes of earlier investigations [12, 13, 23].
We relied on critically sick patients in this study because we wanted to verify the reliability of POCT under certain situations, such as shock. Under high conditions of pH, temperature, electrolyte abnormalities, and hypoglycemia, there are consequently few data points from which to draw conclusions regarding the dependability of specific analyzers.
Limitation of the study
The sample size was rather modest. This is a single-centre study. Blood was collected by various nurses. Bias induced by the design, manufacture, or use of a monitor.
In conclusion, Except for arterial blood glucose, the results of POCT and standard laboratory analysis of glucose concentrations in critically sick patients did not differ significantly in this investigation. Compared to laboratory blood analysis, the use of POCT is marginally accurate, with no difference between shocked and non-shocked patients.