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Understanding the Hematocrit Effect on Glucose Testing Using Popular Point-of-Care Testing Devices

Tirimacco, Rosy BSc; Siew, Limei BMdSc; Simpson, Paul A. BLabMed; Cowley, Penelope J. BLabMed; Tideman, Philip A. FRACP

Point of Care: The Journal of Near-Patient Testing & Technology: December 2014 - Volume 13 - Issue 4 - p 128–131
doi: 10.1097/POC.0000000000000040
Original Articles

Abstract: The use of point-of-care testing (PoCT) blood glucose meters has spread from their intended purpose in the home environment to hospital wards often without appropriate evaluation or understanding of the meter’s limitations. There is substantial evidence that many of the commonly used PoCT blood glucose meters are adversely affected by hematocrit, and their use in intensive care units or on neonates may potentially lead to errors in patient care and an increased risk of iatrogenic or undetected hypoglycemia or hyperglycemia.

We explored the hematocrit interference on 3 glucose meters commonly used in hospital care: the Nova StatStrip Xpress, Abbott Optium Xceed, and Roche Accu-Chek Performa. Hematocrit interference was also investigated on 2 PoCT blood gas and electrolyte instruments: the Abbott i-STAT and Alere epoc. Determining the hematocrit interference on the PoCT blood gas and electrolyte instruments creates the opportunity for hospitals without on-site laboratories to confirm suspect results from blood glucose meters that may have been affected by hematocrit. In country South Australia, there are 55 hospitals without a laboratory that, until recently, relied solely on blood glucose meters for glucose results. All of these hospitals now have either an epoc or i-STAT, which can be used to confirm unexpected abnormal glucose results.

The Nova StatStrip Xpress showed the least interference from hematocrit followed by the Accu-Chek Performa and Optium Xceed. Results of this study confirmed that the i-STAT and epoc are suitable to be used as a backup confirmatory test if glucose meters are adversely affected by hematocrit.

From the Integrated Cardiovascular Clinical Network, Country Health South Australia, Bedford Park, South Australia.

Reprints: Rosy Tirimacco, BSc, Mail Box 28, Level 3B, Mark Oliphant Bldg, Laffer Dr, Bedford Park, South Australia 5042. E-mail: rosy.tirimacco@health.sa.gov.au.

Conflicts of interest and source of funding: This research study was funded by the Australian Medical & Scientific Ltd, distributers of the Nova StatStrip Xpress meter in Australia.

© 2014 by Lippincott Williams & Wilkins