Correspondence  |   May 2018
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Author Notes
  • Mayo Clinic, Rochester, Minnesota (T.B.C.).
  • (Accepted for publication January 31, 2018.)
    (Accepted for publication January 31, 2018.)×
Article Information
Correspondence   |   May 2018
In Reply
Anesthesiology 5 2018, Vol.128, 1045-1046. doi:10.1097/ALN.0000000000002150
Anesthesiology 5 2018, Vol.128, 1045-1046. doi:10.1097/ALN.0000000000002150
We thank Drs. Liang and Rice for their insightful comments on our study.1  There is no widely used or accepted reference method for blood glucose; therefore, the reference method used is a potentially confounding variable in studies of glucose meter accuracy. Perhaps the best choice for any study would be the predicate method for the device being studied, which for the Nova StatStrip (Nova Biomedical Corporation, USA) would be the plasma hexokinase method. The choice of reference method, however, needs to be weighed against other logistical aspects of study design. Specifically, cellular glycolysis occurring in the reference sample increases glucose meter bias as a function of time between sample draw and analysis.2  We chose a study design that allowed us to analyze reference samples within 10 min of blood draw (a practice used in studies intended for U.S. Food and Drug Administration review). However, this required using the whole blood glucose oxidase method on a Radiometer ABL90 (Radiometer America Incorporated, USA) in a laboratory located adjacent to the operating room as the reference method. This method was shown to have no systematic bias compared to a plasma hexokinase method, very good precision (CV 2.1%), and be unaffected by common sources of interference such as hematocrit, pH, and PO2.3  In our practice, we have observed that Radiometer ABL90 glucose is interchangeable with Roche (USA) plasma hexokinase glucose.
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