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Evaluation of different POCT devices for glucose measurement in a clinical neonatal setting

Roth-Kleiner, Matthias ; Stadelmann Diaw, Corinne ; Urfer, Jocelyne ; Ruffieux, Christiane ; Werner, Dominique

In: European Journal of Pediatrics, 2010, vol. 169, no. 11, p. 1387-1395

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    Titel
    • Evaluation of different POCT devices for glucose measurement in a clinical neonatal setting
    Autor
    • Roth-Kleiner, Matthias. Division of Neonatology, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Av Pierre Decker, CH-1011, Lausanne, Switzerland
    • Stadelmann Diaw, Corinne. Division of Neonatology, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Av Pierre Decker, CH-1011, Lausanne, Switzerland
    • Urfer, Jocelyne. Department of Interdisciplinary Centers and Medical Logistic and Department of Pediatrics, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
    • Ruffieux, Christiane. Center of Clinical Epidemiology, Institute of Social and Preventive Medicine, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
    • Werner, Dominique. Central Clinical Chemistry Laboratory, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
    Dokumententyp
    • Postprint
    Sprache
    • Englisch
    Veröffentlicht in
    • European Journal of Pediatrics, 2010, vol. 169, no. 11, p. 1387-1395. Springer-Verlag
    Andere elektronische Ausgabe
    OAI-PMH-ID
    • oai:doc.rero.ch:310787
    Summary
    Hypoglycaemia is a major cause of neonatal morbidity and may induce long-term developmental sequelae. Clinical signs of hypoglycaemia in neonatal infants are unspecific or even absent, and therefore, precise and accurate methods for the assessment of glycaemia are needed. Glycaemia measurement in newborns has some particularities like a very low limit of normal glucose concentration compared to adults and a large range of normal haematocrit values. Many bedside point-of-care testing (POCT) systems are available, but literature about their accuracy in newborn infants is scarce and not very convincing. In this retrospective study, we identified over a 1-year study period 1,324 paired glycaemia results, one obtained at bedside with one of three different POCT systems (Elite™ XL, Ascensia™ Contour™ and ABL 735) and the other in the central laboratory of the hospital with the hexokinase reference method. All three POCT systems tended to overestimate glycaemia values, and none of them fulfilled the ISO 15197 accuracy criteria. The Elite XL appeared to be more appropriate than Contour to detect hypoglycaemia, however with a low specificity. Contour additionally showed an important inaccuracy with increasing haematocrit. The bench analyzer ABL 735 was the most accurate of the three tested POCT systems. Both of the tested handheld glucometers have important drawbacks in their use as screening tools for hypoglycaemia in newborn infants. ABL 735 could be a valuable alternative, but the blood volume needed is more than 15 times higher than for handheld glucometers. Before daily use in the newborn population, careful clinical evaluation of each new POCT system for glucose measurement is of utmost importance