Critically Ill Glucose tests

As just another moderately complex analyzer, I regularly compare our blood gas analyzers to our main lab chemistry analyzer and they compare just fine.  

As it's really just bedside glucose device manufacturers that issued the warning about reliability with critically ill patients, I don't think there's any reason to suspect there to be a problem with other analyzers, unless they would issue a similar warning - and I've not heard of any.  

Hello, 

Can you share the definition of "critically ill" used at your facility?

At what point do you stop the bedside glucometer and start using the moderately complex analyzer?

Thank you!

We use the Nova StatStrip meter and our definition of critically ill is as follows:

>18 Years of Age - Mean Arterial Pressure <60 for greater than 15 minutes.

<18 Years of Age - Birth to one month:  Mean Arterial Pressure below gestational age in weeks for longer than 15 minutes.  >one month:  Systolic blood pressure lower than guidelines provided by the American Heart Association in the Pediatric Advanced Life Support Course for more than 15 minutes. Patients are no longer considered critically ill for the purpose of blood glucose monitoring once their systolic blood pressure is above said guidelines and maintained for longer than an hour without requiring the administration of vasopressor medications.

Patient with Diagnosis of Diabetic Ketoacidosis or Hyperglycemic Hyperosmolar non-ketotic syndrome - Patients are no longer considered critically ill for the purpose of blood glucose monitoring once they are no longer receiving insulin by continuous intravenous infusion or HCOɜ > 14.

Also stated in SOP:  If a capillary whole blood glucose result is not consistent with a patient's clinical signs and symptoms, glucose testing should be repeated with either an arterial or venous specimen on the StatStrip Glucose Hospital Meter System or alternate methodology.