A prospective study of blood glucose detection using arterial blood gas analysis and peripheral glucometry after cardiac surgery with cardiopulmonary bypass: accuracy and influences

The objectives of this study were to evaluate the accuracy of blood glucose measurements and to analyze the clinicopathological and experimental factors affecting the accuracy of blood glucose measurement devices. The study enrolled 172 patients who underwent cardiac surgery with cardiopulmonary bypass. Arterial, peripheral, and venous blood samples were collected simultaneously every hour to 10 hours after surgery. The arterial, peripheral, and venous blood glucose levels were detected by using an arterial blood gas analyzer, blood glucose monitoring system, and laboratory-based automatic biochemistry analyzer, respectively. We determined that blood glucose levels increased after surgery, peaked at postoperative 6 hours, and then decreased to levels similar to those measured at 2 hours after the surgery. Unacceptable error rates of the glucose meter were significantly greater than error rates of the blood gas analyzer at all time points. Clinical factors influencing the measurement of the arterial blood glucose level included the venous blood glucose level and hematocrit. In conclusion, our results indicate that exclusive use of peripheral glucometry for patients recovering from cardiac surgery with cardiopulmonary bypass may lead to inaccurate measurement of blood glucose. Furthermore, perioperative glycemic control should take a patient’s unique clinical characteristics into account.