ArticleCritical care medicine2010
Anemia causes hypoglycemia in intensive care unit patients due to error in single-channel glucometers: methods of reducing patient risk.
Article in Critical care medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 61 citations in OpenAlex.
- Comparison of Space Glucose Control and Routine Glucose Management Protocol for Glycemic Control in Critically Ill Patients: A Prospective, Randomized Clinical Study.Chinese medical journal · 2017Trial
- Hypoglycemic episodes predict length of stay in patients with acute burns.Journal of critical care · 2021Article
- Accuracy of Blood Glucose Measurement and Blood Glucose Targets.Journal of diabetes science and technology · 2020Review
- Comparative performance assessment of point-of-care testing devices for measuring glucose and ketones at the patient bedside.Journal of diabetes science and technology · 2015Article
- Glucose control in intensive care: usability, efficacy and safety of Space GlucoseControl in two medical European intensive care units.BMC endocrine disorders · 2014Article
- Clinical review: Glucose control in severely burned patients - current best practice.Critical care (London, England) · 2013Review
- [Glucose control in the critically ill. Innovations and contemporary strategies].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2013Article
- Glycemic management in medical and surgical patients in the non-ICU setting.Current diabetes reports · 2013Review
- Impact of hypoglycemia in hospitalized patients.Current diabetes reports · 2013Review
- Article
- Signals from fat after injury: plasma adipokines and ghrelin concentrations in the severely burned.Cytokine · 2013Article
- Glycemic targets and approaches to management of the patient with critical illness.Current diabetes reports · 2012Review
- Blood glucose measurements in critically ill patients.Journal of diabetes science and technology · 2012Review
- Hypoglycaemia in severe malaria, clinical associations and relationship to quinine dosage.BMC infectious diseases · 2010Article
- Glycemic control in the burn intensive care unit: focus on the role of anemia in glucose measurement.Journal of diabetes science and technology · 2009Review
- Diabetes does not influence selected clinical outcomes in critically ill burn patients.Journal of burn care & research : official publication of the American Burn AssociationArticle
Corrections and comments
- Commented on by
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveIntensive insulin therapy in the critically ill reduces mortality but carries the risk of increased hypoglycemia. Point-of-care blood glucose analysis is standard; however, anemia causes falsely high values and potentially masks hypoglycemia. Permissive anemia is practiced routinely in most intensive care units. We hypothesized that point-of-care glucometer error due to anemia is prevalent, can be corrected mathematically, and correction uncovers occult hypoglycemia during intensive insulin therapy.
designThe study has both retrospective and prospective phases. We reviewed data to verify the presence of systematic error, determine the source of error, and establish the prevalence of anemia. We confirmed our findings by reproducing the error in an in vitro model. Prospective data were used to develop a correction formula validated by the Monte Carlo method. Correction was implemented in a burn intensive care unit and results were evaluated after 9 mos.
settingBurn and trauma intensive care units at a single research institution. PATIENTS/SUBJECTS: Samples for in vitro studies were taken from healthy volunteers. Samples for formula development were from critically ill patients who received intensive insulin therapy.
interventionsInsulin doses were calculated based on predicted serum glucose values from corrected point-of-care glucometer measurements. MEASUREMENTS AND MAIN
resultsTime-matched point-of-care glucose, laboratory glucose, and hematocrit values. We previously found that anemia (hematocrit <34%) produces systematic error in glucometer measurements. The error was correctible with a mathematical formula developed and validated, using prospectively collected data. Error of uncorrected point-of-care glucose ranged from 19% to 29% (p < .001), improving to < or = 5% after mathematical correction of prospective data. Comparison of data pairs before and after correction formula implementation demonstrated a 78% decrease in the prevalence of hypoglycemia in critically ill and anemic patients treated with insulin and tight glucose control (p < .001).
conclusionsA mathematical formula that corrects erroneous point-of-care glucose values due to anemia in intensive care unit patients reduces the prevalence of hypoglycemia during intensive insulin therapy.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.