Apparent high chloraemia in persons with deep third-degree burns: Interference linked to topical treatment

Chianéa, Denis; Delaune, D.; Monpeurt, Corinne; Vest, Philippe; Bargues, L.; Renard, Christophe

doi:10.1016/j.burns.2009.07.002

Cited by 4 publications

(2 citation statements)

References 2 publications

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“…A paper by Chianea et al 7 described similar casesthey observed some patients with third degree burns had unexpected hyperchloraemia when measured by their blood gas analyser (ABL 700, Radiometer). However, unlike our case, it also interfered with their automated analyser chloride ISE (Cobas Integra 800, Roche Diagnostics) albeit to a lesser degree.…”

Section: Nitrate Interference On Chloride Isementioning

confidence: 93%

Falsely raised whole blood chloride caused by systemic absorption of cerium nitrate cream for burns

Woollard

Chiu

2014

Ann Clin Biochem

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Whole blood, serum or plasma chloride is almost exclusively measured by potentiometry with an ion-selective chloride electrode which utilizes membrane selectivity to chloride ions. Other anions such as bromide, iodide and thiosulphate can interfere but usually are not present in high enough concentration to cause significant cross reactivity. A patient from our burns unit had serial chloride measurements on a Radiometer ABL800 blood gas analyser. The results were higher in contrast to plasma measurements on the Abbott Architect Ci8200, which were within reference intervals and in line with the patient's pathophysiological status. This indicated a likely interference with the blood gas analyser chloride estimation. The chloride results on the ABL800 for 3rd, 4th and 5th day after the burn accident were 170, 137 and 119 mmol/L. Corresponding plasma chloride results on the Ci8200 were all around 105 mmol/L. Nitrate was found to be markedly elevated in these samples, and the results were 6.7, 4.9 and 1.1 mmol/L, respectively (reference limit-< 0.08 mmol/L). To further demonstrate nitrate was the causative agent, pooled plasma spiked with 7 mmol/L of sodium nitrate caused a rise in the ABL800 chloride from 105 to 202 mmol/L. Later we confirmed that the patient was topically medicated with cerium nitrate cream (Flammacerium Õ , Sinclair IS Pharma, UK) for his burns. In summary, the results clearly indicated nitrate was the interferent with the ABL800 chloride estimation and the source was the topical burns cerium nitrate cream.

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Section: Nitrate Interference On Chloride Isementioning

confidence: 93%

Falsely raised whole blood chloride caused by systemic absorption of cerium nitrate cream for burns

Woollard

Chiu

2014

Ann Clin Biochem

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“…Sir, Nitrate species reportedly interfere with blood chloride measurement by ion selective electrodes (ISEs), which are commonly used to measure chloride in clinical laboratories. This phenomenon has been described with multiple instruments, including ABL700 and ABL800 (Radiometer Medical, Denmark), 1,2 and Cobas Integra (Roche Diagnostics, USA) 3 . There is evidence that nitrate anions do not interfere with chloride measurements on Ci8200 Architect (Abbott Diagnostics, USA).…”

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confidence: 96%