What antidote for a critically poisoned patient can interfere with point-of-care (POC) glucose measurements?
In a patient treated with hydroxocobalamin after rescue from a house fire, POC glucose measurements averaged 61 mg/dL (3.4 mmol/L) lower than glucose measured in a basic metabolic panel (BMP). The patient twice received IV dextrose due apparent POC glucose result of <20 mg/dL).
The authors spiked plasma with different concentrations of hydroxocobalamin and found that POC glucose decreased by up to 25% at higher HC concentrations while BMP glucose remained stable.
Other interferences in the spiked samples included increases in creatinine (up to 90% increase) and POC lactate (up to 40% increase).
Sauer MA, Rizzo NM, Tolan NV. Impact of Cyanokit Administration on Point-of-Care Glucose and Laboratory Test Accuracy. Clin Chem 2022; 68:504–508. https://doi.org/10.1093/clinchem/hvac014
Contributed by: Michael Mullins, MD