Accurate measurement of the blood glucose concentration requires not only the use of accurate analyzers but also standardized blood sampling and handling. selleck catalog Pre-analytical errors arise due to variable blood sampling and handling, and these errors may be larger than those arising from the use of inaccurate analyzers.Point-of-care devices were not designed for ICU use or to be used to regulate insulin infusions in critically ill patients. The ICU is a unique environment where readings from glucose meters may be subject to further inaccuracies due to rapid changes in hematocrit or oxygenation and interference from medications and other physical or chemical factors [13]. In response to these concerns, newer glucose meters try to correct known problems – and monitors capable of continuous or automated intermittent measurement of blood glucose are being developed specifically for use in the ICU.

A further issue is the assessment and reporting of glycemic control [3]. Glycemic control can be reported in many different ways with a focus on different measures of central tendency (mean, median, mode, and so forth) and dispersion (standard deviation, range, interquartile range). Within these domains the dimension of time also has to be considered along with the impact of the frequency with which blood glucose concentration is measured. This consideration has resulted in glycemic control being reported in many different ways, which introduces further difficulty when trying to assess the adequacy of glycemic control and to understand and to compare the results of the various clinical trials.

In light of the uncertainties in this area we convened a meeting of interested parties and experts plus invited observers from industry to discuss and where possible reach consensus on the most appropriate methods to measure and monitor blood glucose in critically ill patients and Anacetrapib on how glycemic control should be assessed and reported. Recognizing their clear conflict of interest, industry observers played no role in developing the consensus or recommendations from the meeting. Where the academic participants could not reach consensus, they sought to make recommendations on further research and data needed to reach consensus in the future.