Point of Care Glucose Testing in Neonatal Hypoglycemia

Abstract

Abstract: Neonatal hypoglycemia is a common problem in nurseries and has been associated with adverse neurodevelopmental consequences. Detection of hypoglycemia in the neonate requires accurate and reliable measurement of blood glucose concentrations. Point of care testing devices have advanced the ability of caretakers to rapidly monitor blood glucose levels at the bedside. However, care must be taken when interpreting low glucose measurements on point of care testing devices in the neonatal population. Although no device has been definitively shown to satisfy guidelines set forth by the National Committee for Clinical Laboratory Standards and the American Diabetic Association in measuring low glucose values, some do show higher sensitivities and negative predictive values. The clinical status of the patient and the inherent bias within the device can have a significant impact on the accuracy of the glucose measurements and must be kept in mind when interpreting results. In addition, adherence to quality control and attention to storage and to the expiration of reagents are crucial. It is best to involve a multidisciplinary committee involving clinical and laboratory personnel to choose the appropriate device, perform appropriate validation studies, and monitor its effectiveness.