SESSION TITLE: Disorders of the Pleura Posters
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM
PURPOSE: Pleural fluid glucose levels are used extensively to evaluate pleural effusions. A low level has diagnostic, prognostic, and therapeutic implications for patients with parapneumonic effusions. Levels below 60 mg/dL usually necessitate the drainage of the pleural fluid by tube thoracostomy. The literature examining point-of-care testing of pleural fluid glucose is limited. We compared the conventional in-lab pleural fluid glucose measurements to the bedside measurements done using a regular finger stick glucometer.
METHODS: Patients at the Oklahoma City VA undergoing diagnostic thoracentesis for pleural effusion were enrolled in the study. Pleural fluid glucose was measured at the bedside with a finger stick blood glucometer (ACCU-CHekR Inform II, Roche) and in the laboratory. To evaluate the intra-assay precision, two consecutive measurements were taken using the glucometer. The mean of the 2 measurements was then compared to the glucose value measured in the laboratory.
RESULTS: A total of 23 patients were enrolled in the study. The mean difference between the 2 glucometer measurements was 0.9±4.6 mg/dL (Range -11 to 10 mg/dL) suggesting a good intra-assay precision. There was a significant correlation between the pleural glucose laboratory value and the mean pleural glucose glucometer value (R2=0.94, p<0.01). Bland-Altman plot analysis of the laboratory value and the mean glucometer value showed a strong correlation when the pleural fluid glucose values were below 100 mg/dL.
CONCLUSIONS: Our study shows a good correlation between the pleural fluid glucose measured in the laboratory and the pleural fluid glucose measured at the bedside with a finger stick glucometer. This correlation is especially significant at glucose levels below 100 mg/dL.
CLINICAL IMPLICATIONS: Pleural fluid glucose measurement using finger stick glucometer is much faster compared to the traditional in-lab testing. Showing a good correlation between the 2 methods may allow clinicians to make faster decisions regarding the need for pleural fluid drainage in the correct clinical settings. It would also allow the clinician to combine the diagnostic and therapeutic procedures, eliminating the need for 2 distinct interventions.
DISCLOSURE: The following authors have nothing to disclose: Himanshu Bhardwaj, Muhammad Ishaq, Jean Keddissi, Houssein Youness
We will be discussing the use of finger stick blood glucometers in measuring pleural fluid glucose levels.