Precision-to-tolerance capability: an important consideration in tight glucose control.
OBJECTIVE: To assess clinical implications of bias and variance of point-of-care glucometric measurements in cardiac surgery patients with wide variations in postoperative hematocrit. METHODS: Point-of-care glucose measurements were compared with values from laboratory analysis of the same sample of...
| Publicado en: | American Journal of Critical Care Vol. 18; no. 3; pp. 232 - 240 |
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| Autores principales: | , , , , |
| Formato: | equations & formulas research tables/charts Journal Article |
| Publicado: |
American Association of Critical-Care Nurses
May2009
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105533047&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105533047 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10623264 44L jtl: American Journal of Critical Care issn: 10623264 maglogo: N pubinfo: dt: May2009 vid: 18 iid: 3 pid: 2559 pub: American Association of Critical-Care Nurses place: Alisa Veijo, California artinfo: ui: 105533047 2010283084 10.4037/ajcc2009262 NLM19411583 105533047 ppf: 232 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Precision-to-tolerance capability: an important consideration in tight glucose control. aug: au: Prinzing C Rosenlund S Sukeena V Malinowski C Wise LC affil: Trinity Health-Saint Alphonsus Regional Medical Center in Boise, Idaho. USA. sug: subj: Cardiac Patients Critically Ill Patients Glycemic Control Point-of-Care Testing Surgical Patients Analysis of Variance Blood Glucose Meters Economics Blood Specimen Collection Clinical Nursing Research Comparative Studies Confidence Intervals Convenience Sample Descriptive Statistics Equipment Reliability Hematocrit Idaho Intensive Care Units Laboratories Human ab: OBJECTIVE: To assess clinical implications of bias and variance of point-of-care glucometric measurements in cardiac surgery patients with wide variations in postoperative hematocrit. METHODS: Point-of-care glucose measurements were compared with values from laboratory analysis of the same sample of whole blood obtained from cardiac patients early on postoperative days 1 and 2. Twenty nurses collected 89 arterial blood samples from 58 patients during a 4-month period. Bias was measured by using difference scores between paired measurements. Patients were grouped within 5% increments according to hematocrit, and analysis of variance was used to test for differences. Variation was analyzed by precision-to-tolerance analysis within 3 euglycemic tolerance ranges. RESULTS: Laboratory glucose values were 62 to 224 mg/dL; point-of-care measures were 83 to 253 mg/dL. Bias was 10.85 mg/dL across all hematocrit groups. Pairs of laboratory and point-of-care glucose values differed significantly (t(174) = 10.03; P < .001). Bias increased from -2.83 mg/dL for patients with hematocrits exceeding 39% to +16.71 mg/dL for patients with hematocrits between 20% and 24%. The standard deviation of difference scores was 11.59 mg/dL overall. The difference between 5% hematocrit groups was significant (F(4) = 4.11; P = .004). Precision-to-tolerance capability ratios for specification limits of 70 to 300, 90 to 140, and 80 to 110 mg/dL were 0.30, 1.39, and 2.32, respectively. CONCLUSIONS: The direction of bias change between hematocrit groupings was the direction predicted in the manufacturer's information. Precision-to-tolerance measures indicated that the point-of-care equipment was not suitable for testing glucose within the planned 'tighter' glycemic standards. pubtype: Academic Journal doctype: equations & formulas research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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