74 /

Size: px

Start display at page:

Download "74 /"

신일 애
6 years ago
Views:

1 Evaluation of Fingerstick Blood Glucose in Hypotensive Patients Dong Wun Shin, M.D., Jun Sig Kim, M.D., Seung Baik Han, M.D., Jun Hee Lee, M.D., Ah Jin Kim, M.D., Ji Hye Kim, M.D., Woong Khi, M.D., Sung Tae Ahn, M.D., Yong Joo Lee, M.D. 1, and Kwang Je Baek, M.D. P u r p o s e: Due to its rapidity and easy accessibility, the fingerstick blood glucometer has been used in almost all hospitals and private clinics, and even by patients themselves. We also have used it even in shock patient care, but shock shows global tissue hypoperfusion, especially in peripheral tissue. The changes of peripheral circulation have an influence on the results for fingerstick glucose. To evaluate the accuracy of the glucometer for patients with poor peripheral perfusion, we designed this s t u d y. M e t h o d s: A prospective, nonrandomized comparison group study was done. A hypotensive group and a normotensive group were compared. We obtained three data from each patient: venous blood glucose level (clinicopathologic laboratory), venous blood glucose level (by glucometer) and fingerstick glucose level (by g l u c o m e t e r ). R e s u l t s: We saw a significant difference between the fingerstick glucometer results and the laboratory glucose levels in hypotensive patients: mg/dl vs mg/dl (paired t-test, p<0.05). There was no significant difference between fingerstick and laboratory glucose in normotensive patients: mg/dl vs mg/dl (paired t-test, p>0.05). There was no significant difference between the results of venous glucometer and laboratory test in either group: mg/dl vs mg/dl (paired t-test, p>0.05) and mg/dl vs mg/dl (paired t-test, p>0.05). Although some statistical differences existed between the results, all of the error rates were in an acceptable range (within 15%, accepted by American Diabetes Association consensus). C o n c l u s i o n: These results suggest that the blood glucose level of the glucometer with venous blood is more accurate than that with peripheral blood in patients with poor peripheral circulation. Key Words: Shock, Glucometer Department of Emergency Medicine, Inha University Medical School, Incheon, Korea Department of Emergency Medicine, Seoul Adventist Hospital, Seoul, Korea 1 73

2 74 /

3 75

4 76 /

5 Sherwood MJ, Warchal ME, Chen ST: A New Reagent Strip(Visidextm) for Determination of Glucose in Whole Blood, Clin Chem 29:438-46, Glucotrend plus glucose 15 sec(insert paper), R o c h e Diagnositics GmbH 16. Cryer PE: Hypoglycemia: In Braunwald E, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL editors. H a r r i s o n s Principles of Internal Medicine. 15th ed. p , McGraw- Hill, Aghababian RV, Allison EJ, Braen GR et al. eds. Emergency Medicine. The Core Curriculum. p210-1, Lippincott-Raven, Karen CM, Atul M, Bruce RB: Stress induced hyperglycemia. Crit Care Clin Jan;17(1):107-24, Mullner M, Sterz F, Binder M, Schreiber W, Deimel A, Laggner AN: Blood glucose concentration after cardiopulmonary resuscitation influences functional neurological recovery in human cardiac arrest survivors. J Cereb Blood Flow Metab Apr;17(4):430-6, Longstreth WT Jr, Inui TS: High blood glucose level on 13. American Diabetes Association : Consensus statement on selfmonitoring of blood glucose. Diabetes Care 17:81-86, hospital admission and poor neurological recovery after cardiac arrest. Ann Neurol Jan;15(1):59-63, Wass CT, Lanier WL : Glucose modulation of ischemic brain injury : Review and clinical recommandations. Mayo Clin Proc 71:804-12, American Diabetes Association : Consensus statement on self- monitoring of blood glucose. Diabetes Care 10:95-99, Hussain K, Sharief N: The inaccuracy of venous and capillary blood glucose measurement using reagent strips in the newborn period and the effect of haematocrit. Early Hum Dev Feb;57(2) , Lin HC, Maguire C, Oh W, Cowett R: Accuracy and reliablity of glucose reflectancemeters in the high-risk neonate. J Pediatr 115: , Rivers EP, Rady MY, Bilkovski R: Approach to the patient in shock: Tintilnalli JE, Kelen GD, Stapczynski JS editors. Emergency Medicine. A comprehensive study guide.(acep) 5th ed.p , McGraw-Hill, Pointer JE: Glucose analysis: Indications for ordering and 17. Thomas SH, Gough JE, Benson N, Austin PE, Stone CK : alternatives to the laboratory. Ann Emerg Med 15 : 372-6, Accuracy of fingerstick glucose determination in patients receiving CPR. South Med J Nov;87(11): , Paul EK, Ruth SW, John BN: Carbohydrates: In Henry JB, 18. Atkin SH, Dasmahapatra A, Jaker MA, Chorost MI, editors. Clinical Diagnosis and Management by Laboratory Methods. 12th ed. p214, WB Saunders, Intern Med 114:1020-z4, Reddy S: Fingerstick glucose determination in shock. Ann 13. Kaufmann N, Weime J, Pfrang I, Lee D: Evaluation of a 19. Sylvain HF, Pokorny ME, English SM et al.: Accuracy of New, Improved Test Strip for Determining Blood Glucose fingerstick glucose values in shock patients. Am J Crit with a Glucotrend Monitor. 1st ed.p3-11, R o c h ed i a g n o t i c s Care Jan;4(1):44-8, G m b H, 2000.

012임수진

012임수진 Received : 2012. 11. 27 Reviewed : 2012. 12. 10 Accepted : 2012. 12. 12 A Clinical Study on Effect of Electro-acupuncture Treatment for Low Back Pain and Radicular Pain in Patients Diagnosed with Lumbar