Detecting hypoglycemia in venous blood: Comparison of two neonatal bedside glucose monitors

We evaluated the performance of the One Touch II Hospital in neonatal mode (Lifescan, Militipas, Calif) and Accu-Chek II (Boehringer Mannheim, Indianapolis) in screening for neonatal hypoglycemia. We used blood with low- to-normal glucose concentrations and a wide range of hematocrits to mimic infant blood. Single-donor adult blood was collected in heparinized tubes and allowed to metabolize overnight. Red blood cells were separated and reconstituted with the plasma, normal saline, and 10% dextrose to 5 hematocrits and 6 approximate plasma glucose concentrations. All 30 combinations of hematocrit and glucose concentration were tested. The One Touch II Hospital glucose monitor showed the best accuracy of numeric results (32%-78% vs 11%-54%), precision (pooled standard deviation, 1.4 mg/dL vs 4.6- 13.9 mg/dL), and correlation (Pearson's r, 0.95-0.98 vs 0.82-0.86). Sensitivity and specificity for hypoglycemic glucose levels were statistically similar.