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Original Research and Critical Analysis

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

Richard F. Louie, PhD, Stephanie L. Sumner, Shaunyé Belcher, Ron Mathew, BS, Nam K. Tran, PhD and Gerald J. Kost, MD, PhD, MS, FACB

Address correspondence and reprint requests to Dr Richard F. Louie, Point-of-Care Testing Center for Teaching and Research, Pathology, and Laboratory Medicine, 3448 Tupper Hall, University of California, Davis, CA 95616 (e-mail: rflouie{at}ucdavis.edu).

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.

Key Words: blood gas • error • glucose meter • handheld blood gas analyzer • stress duration




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R. F. Louie, T. Kitano, T. K. Brock, R. Derlet, and G. J. Kost
Point-of-Care Testing for Pandemic Influenza and Biothreats
Disaster Med Public Health Preparedness, December 1, 2009; 3(Supplement_2): S193 - S202.
[Abstract] [Full Text] [PDF]