Accuracy and stability evaluation of different blood sampling methods in blood gas analysis in emergency patients: A retrospective study

Abstract

Background To evaluate the accuracy and stability of arterial blood gas (ABG) results by comparison with venous measurements from routine blood tests, and to compare the accuracy and performance of two sampling syringes, pre‐heparinized syringe (PHS) and disposable arterial blood syringe (DABS), in ABG analysis. Methods We retrospectively analyzed the practical use of PHS and DABS in collecting ABG samples, involving 500 and 400 patients, respectively. For each patient, in addition to the ABG sample, a venous blood sample was also collected using a venous blood collection tube (VBCT) and used for routine blood tests. Accordingly, patients were referred to as the PHS + VBCT group and DABS + VBCT group. The correlation between arterial and venous values of each blood parameter in each group was evaluated using the interclass correlation coefficient (ICC). Bland–Altman was performed to evaluate the agreement between arterial and venous values and compare the performance of PHS and DABS in ABG sample collection. Results In the PHS + VBCT group, arterial K+, Na+, hemoglobin (Hb), and hematocrit (HCT) were 0.32 mmol/L, 2.90 mmol/L, 2.21 g/L, and 1.27% significantly lower their corresponding venous values while arterial Cl− was 7.60 mmol/L significantly higher than venous Cl−. In the DABS + VBCT group, arterial K+ and Na+ were 0.20 mmol/L and 1.19 mmol/L significantly lower while Cl− and HCT in arterial blood were 5.34 mmol/L and 0.66% significantly higher than their corresponding venous values. In both groups, arterial K+, Na+, Hb, and HCT values were highly consistent with their corresponding venous values, with all ICCs greater than 0.70, especially Hb and HCT. Bland–Altman analysis demonstrated that arterial K+ and Na+ were more consistent with venous counterparts in the DABS + VBCT group, with a narrower 95% limits of agreement than the PHS + VBCT group (K+, −0.7‐0.3 mmol/L vs. −1.1 to 0.5 mmol/L; Na+, −5.8 to 3.4 mmol/L vs. −8.2 to 2.4 mmol/L). Conclusion Arterial blood gas analysis of K+, Na+, Hb, and HCT using PHS or DABS for blood sampling is accurate and stable, especially DABS, which can provide clinicians with fast and reliable blood gas results.

Comparison of arterial blood gas results obtained using two types of Heparinized Syringes

“…Apart from respiratory parameters, electrolytes like sodium, potassium and calcium are also susceptible to changes due to heparin. Heparin being negatively charged tend to bind cations in blood leading to falsely low levels of cations like potassium and calcium [18][19][20] . Dry heparin syringes not only provide less biased blood gas and electrolyte results but are ergonomically designed to allow one hand operation, minimizing needle prick incidents and are less painful for the patient as well 21 .…”

Analysis of arterial blood gas values when discarding different volumes of blood samples in an arterial heparin blood collector during thoracoscopic surgery

“…Different injectors often also make a difference. The accuracy and stability of ABGA differ between disposable arterial blood injectors and preheparin injectors [ 10 ]. These studies suggest that subtle differences in detection methods can have a significant impact on blood gas results and that simpler measurement methods may yield equally accurate results.…”