Abstract
Objective
To compare glucose measurements from capillary and venous blood samples using a point-of-care (POC) glucometer with a standard laboratory (colorimetric, glucose oxidase) assay (LABGLU) in a population of hospitalized, neonatal foals.
Design
Multicenter, prospective, experimental study, conducted between March 2019 and June 2020.
Setting
Four university teaching hospitals and 1 private referral hospital.
Animals
Fifty-four hospitalized neonatal (≤30 days of age) foals.
Interventions
Simultaneous capillary (muzzle, POCMUZ) and venous (jugular, POCJUG) blood samples were obtained to determine POC glucose concentrations. Venous samples were also analyzed by LABGLU. Each foal was sampled at the time of enrollment or admission to the hospital and at 1 subsequent point during hospitalization. Indirect mean arterial pressure and hematocrit were concurrently recorded.
Measurements and Main Results
Bland–Altman analysis showed a mean bias (95% limits of agreement) of −28.0 (−88.6 to 32.6) mg/dL for comparison of POCJUG with LABGLU, −8.2 (−94.3 to 78.0) mg/dL for POCMUZ and LABGLU, and 18.8 (−44.4 to 82.0) mg/dL for POCMUZ and POCJUG. A total of 63.5% of the POCJUG and 45.2% of the POCMUZ samples exceeded the reference value by ±15 mg/dL (for LABGLU samples <75 mg/dL) or ±15% (for LABGLU samples ≥75mg/dL). Concordance correlation coefficient (95% confidence interval [CI]) indicated a fair agreement between POCJUG and LABGLU (0.75, 95% CI: 0.66–0.82) and between POCMUZ and LABGLU (0.71, 95% CI: 0.58–0.80). Fifty percent (14/28) of hypoglycemic foals on the reference method were incorrectly classified as euglycemic by POCJUG, and 5 of 28 were incorrectly classified by POCMUZ.
Conclusions
In the sampled population, the chosen POC glucometer lacked agreement with the standard laboratory measurement. Limits of agreement were wide for both POCJUG and POCMUZ. Inaccuracies in POC results could impact decision-making in the clinical management of glycemic control in hospitalized neonatal foals and, importantly, increase the risk of hypoglycemic events being underdiagnosed in critical patients.
Journal of Veterinary Emergency and Critical Care, EarlyView.Wiley: Journal of Veterinary Emergency and Critical Care: Table of Contents