Conclusions in the article by Lacara and colleagues1 contradict recent work soon to be published by our laboratory on the accuracy of bedside glucometer testing in the critical care setting. Our findings demonstrate that hematocrit has a significant effect on the accuracy of widely used point-of-care (POC) glucometers, and we noted that this effect becomes clinically meaningful when red cell volume is less than 34%. Many centers practice permissive anemia2,4 to reduce exposure to transfused blood, and the higher prevalence of low hematocrits has reduced the accuracy of POC glucose analyzers.5,6 

The authors discuss the nationally accepted standard error of glucometers of ±20%, but these devices are not intended for intensive care use. Such a degree of inaccuracy is a holdover from a time before tight glucose control became common practice,...

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