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Intralipid causes falsely increased glucose concentrations with the Hemocue glucose analyzer

Performing blood measurements for the neonatal intensive care unit (NICU) is a challenging task. Neonates are extremely small, fragile and have a small blood volume. Despite this, treatment of neonates depends on reliable measurements of many parameters in blood. One of the most frequently measured parameters in the NICU is glucose. We already know from studies in adults how difficult it is to measure glucose quickly and reliably in small volumes of blood (1). In our hospital, technicians from the clinical chemistry laboratory perform glucose measurements in the NICU with the Glusose201DM analyzer (Hemocue, Angelholm, Sweden). This bedside glucose analyzer requires only a small amount of blood (5 mL), and is not significantly influenced by high hematocrits (1), which is a very important consideration in neonates. We studied extensively the correlation between the Glucose201DM analyzer with the hexokinase (Modular, Roche Diagnostics, Rotkreuz, Switzerland) and Ebio (Eppendorf, Hamburg, Germany) method before we introduced the Glucose201DM analyzer into the NICU. In contrast to a previous report (2), this showed very high correlation ()0.97). However, last year we experienced a few cases of large differences between the Glucose201DM analyzer and the Ebio analyzer. The Glucose201DM analyzer gave values of )22.2 mmol/L, whereas confirmation measurements in our laboratory showed glucose concentrations of ;16 mmol/L. Since these neonatal patients received parenteral feeding and no other medicine, we suspected that an increased concentration of lipids might affect the spectrophotometric glucose measurement on the Glucose201DM analyzer. We, therefore, performed an evaluation on the effects of hyperlipemia on glucose concentrations measured with the glucose analyzers available in our laboratory. The four glu-