Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-25T07:55:35.001Z Has data issue: false hasContentIssue false
  • English
  • Français

Thermal Stress and Point-of-Care Testing Performance: Suitability of Glucose Test Strips and Blood Gas Cartridges for Disaster Response

Published online by Cambridge University Press:  08 April 2013

Richard F. Louie ,
Stephanie L. Sumner ,
Shaunyé Belcher ,
Ron Mathew ,
Nam K. Tran  and
Gerald J. Kost
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: Point-of-care testing (POCT) devices are deployed in the field for emergency on-site testing under a wide range of environmental conditions. Our objective was to evaluate the performance of glucose meter test strips and handheld blood gas analyzer cartridges following thermal stresses that simulate field conditions.

Methods: We evaluated electrochemical and spectrophotometric glucose meter systems and a handheld blood gas analyzer. Glucose test strips were cold-stressed (–21°C) and heat-stressed (40°C) for up to 4 weeks. Blood gas cartridges were stressed at –21°C, 2°C, and 40°C for up to 72 hours. Test strip and cartridge performance was evaluated using aqueous quality control solutions. Results were compared with those obtained with unstressed POCT strips and cartridges.

Results: Heated glucose test strips and blood gas cartridges yielded elevated results. Frozen test strips and cooled cartridges yielded depressed glucose and blood gas results, respectively. Frozen cartridges failed.

Conclusions: The performance of glucose test strips and blood gas cartridges was affected adversely by thermal stresses. Heating generated elevated results, and cooling depressed results. Disaster medical assistance teams and emergency medical responders should be aware of these risks. Field POCT devices must be robust to withstand adverse conditions. We recommend that industry produce POCT devices and reagents suitable for disaster medical assistance teams. (Disaster Med Public Health Preparedness. 2009;3:13–17)

Keywords

blood gaserrorglucose meterhandheld blood gas analyzerstress duration
Type
Original Research and Critical Analysis
Information
Disaster Medicine and Public Health Preparedness , Volume 3 , Issue 1 , March 2009 , pp. 13 - 17
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Kost, GJ, Tran, NK, Tuntideelert, M, et alKatrina, the tsunami, and point-of-care testing: optimizing rapid response diagnosis in disasters. Am J Clin Pathol. 2006;126:513–520.CrossRefGoogle ScholarPubMed
2. Disaster Medical Assistant Teams. http://www.hhs.gov/aspr/opeo/ndms/teams/dmat.html. Accessed November 12, 2008.Google Scholar
3.Mace, SE, Jones, JT, Bern, AI. An analysis of Disaster Medical Assistant Team (DMAT) deployments in the United States. Prehosp Emerg Care. 2007;11:30–35.CrossRefGoogle ScholarPubMed
4.Haller, MJ, Shuster, JJ, Schatz, D, et alAdverse impact of temperature and humidity on blood glucose monitoring reliability: a pilot study. Diabetes Technol Ther. 2007;9:1–9.CrossRefGoogle ScholarPubMed
5.Bamberg, R, Schulman, K, MacKenzie, M, et alEffects of adverse storage conditions on performance of glucometer test strips. Clin Lab Sci. 2005;18:203–209.Google ScholarPubMed
6.Bilen, H, Kilicaslan, A, Akcay, G, et alPerformance of glucose dehydrogenase (GDH) based and glucose oxidase (GOX) based blood glucose meter systems at moderately high altitude. J Med Eng Technol. 2007;31:152–156.CrossRefGoogle ScholarPubMed
7.Fink, KS, Christensen, DB, Ellsworth, A. Effect of high altitude on blood glucose meter performance. Diabetes Technol Ther. 2002;4:627–635.CrossRefGoogle ScholarPubMed
8.Devaraja, M, Sridevi, G, Singh, A, et alThermal inactivation of glucose oxidase: mechanism and stabilization using additives. J Biol Chem. 2003;278:24324–24333.Google Scholar
9.Kost, GJ, Tran, NK, Abad, VJ, et alEvaluation of point-of-care glucose testing accuracy using locally smoothed median absolute difference curves. Clin Chim Acta. 2008;389:31–39.CrossRefGoogle ScholarPubMed
10.Kost, GJ, Vu, H, Lee, JH, et alMulticenter study of oxygen-insensitive handheld glucose point-of-care testing in critical care/hospital/ambulatory patients in the United States and Canada. Crit Care Med. 1998;26:581–590.CrossRefGoogle Scholar
11.Tang, Z, Du, X, Louie, RF, et alEffects of drugs on glucose measurements with handheld glucose meters and a portable glucose analyzer for point-of-care testing. Am J Clin Pathol. 2000;113:75–86.CrossRefGoogle Scholar
12.Louie, RF, Tang, Z, Sutton, DV, et alPoint-of-care glucose testing: effects of critical care variables, influence of reference instruments, and a modular glucose meter design. Arch Pathol Lab Med. 2000;124:257–266.CrossRefGoogle Scholar
13.Tang, Z, Lee, JH, Louie, RF, et alEffects of different hematocrit levels on glucose measurements with handheld meters for point-of-care testing. Arch Pathol Lab Med. 2000;124:1135–1140.CrossRefGoogle ScholarPubMed
14.Tang, Z, Louie, RF, Payes, M, et alEffects of changes in PO2 on glucose measurements on glucose meters and a whole-blood reference analyzer. Diabetes Technol Ther. 2000;2:349–362.CrossRefGoogle Scholar
15.Tang, Z, Louie, RF, Lee, JH, et alOxygen effects on glucose meter measurements with glucose dehydrogenase- and oxidase-based test strips for point-of-care testing. Crit Care Med. 2001;29:1062–1070.CrossRefGoogle ScholarPubMed
16.Kost, GJ. Newdemics, public health, small-world networks, and point-of-care testing. Point Care. 2006;5:138–144.Google Scholar