Blood gas analysis: effect of air bubbles in syringe and delay in estimation.

Biswas, Chandan; Ramos, J M; Agroyannis, B.; Kerr, Derek

doi:10.1136/bmj.284.6320.923

Cited by 108 publications

(57 citation statements)

References 7 publications

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“…In addition to the advantages of in situ monitoring under near real-time conditions, problems with discrete arterial blood sampling, such as, systematic errors due to air bubbles (Biswas et al 1982;Harsten et al 1988;Thorson et al 1983), dilution from flush solution (Boidin andJorna, 1984;Hamilton et al 1978), storage temperature, or time delay between sampling and measurement (Kelman and Nunn 1966) were avoided using fiber-optic biosensor technology. The biosensor technology described in this report utilized phosphorescence; however, alternative technological approaches using fluorescence or micro electrodes also have been developed for fiber-optic biosensors (Barker and Hyatt 1991;Mahutte et al 1990;Shapiro 1992;Shapiro et al 1989) and could be similarly applied.…”

Section: Discussionmentioning

confidence: 99%

Application of a Novel Fiber-Optic Biosensor In Situ to Investigate the Metabolic Effect of Lactate Infusion

Dager

Yim

Khalil

et al. 1995

Neuropsychopharmacology

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Recently developed biosensor technology, which allows near real-time measurement in situ of gas tension (pC02 and p02) and of pH, was applied to arterial blood, cerebrospinal fluid (CSF), and brain parenchyma during intravenous lactate infusion in monkeys. Comparison of simultaneous biosensor measurements and discreteto lactate infusion appears to be a sensitive and specific marker for naturally occurring panic attacks (Cowley and Arana 1990).Previous work using mechanically ventilated monkeys to investigate central nervous system (CNS) effects of intravenous sodium lactate infusion reported increases in lactate, as well as delayed increases in pH and bicarbonate using a technique of intermittent direct sampling of cisternal CSF (Dager et al. 1990). Contrary to theories that lactate-induced panic results from peripheral metabolism of lactate to CO2 that then rapidly crosses the blood-brain barrier (Gorman 1989), in the Dager et al. (1990) study CSF pC02 levels did not increase during lactate infusion. However, it is uncertain whether the intermittent removal of cisternal CSF may have affected those results and whether CSF pC02 is representative of parenchymal brain pC02.Accordingly, the present study was designed to continuously monitor gas tension (p02 and pC02) and 0893-133X/95/$9 .50 SSDI 0893-133X(94)00095-H

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Section: Discussionmentioning

confidence: 99%

Application of a Novel Fiber-Optic Biosensor In Situ to Investigate the Metabolic Effect of Lactate Infusion

Dager

Yim

Khalil

et al. 1995

Neuropsychopharmacology

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“…This is different from the situation in clinical practice where pre-analytical errors play a major role, especially for PO 2 . In the preanalytical phase, the blood gas results may be influenced, for example, by: the ventilatory status of the patient before and during blood collection; the blood PO 2 level; the technique of specimen collection; the nature of the specimen container, preparation of the container with anticoagulant; sample handling; cooling of the sample; storage and transport of the specimen; and severe leucocytosis or thrombocytosis [16][17][18][19][20][21][22][23][24][25][26]. This study provides indirect support for the idea that standardization and quality control in the preanalytical phase represent the best strategy to optimize reproducibility of measurements of blood gas values in a clinical setting.…”

Section: Discussionmentioning

confidence: 99%

Instrumental variability of respiratory blood gases among different blood gas analysers in different laboratories

Kampelmacher

Kesteren²,

Winckers³

1997

Eur Respir J

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The aim of this study was to test the hypothesis that differences in oxygen tension (PO 2 ) and carbon dioxide tension (PCO 2 ) values from measurements performed on different blood gas analysers in different laboratories are clinically insignificant.Samples of fresh whole human tonometered blood (PO 2 8.1 kPa (60.8 mmHg); PCO 2 5.3 kPa (39.9 mmHg)) were placed in airtight glass syringes and transported in ice-water slush. Blood gas analysis was performed within 3.5 h by 17 analysers (10 different models) in 10 hospitals on one day.The mean of the differences between the measured and target values was -0. We conclude that the variability in measurement of blood gas values among different blood gas analysers, although negligible, depends much more on inter-than intra-instrument variation, both for oxygen tension and carbon dioxide tension. Technical improvements and adequate quality control programmes, including tonometry, may explain why the variability in blood gas values depends mainly on errors in the pre-analytical phase.

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“…,.,., f , .. . f types of syringe (series I and II), and results (1)(2)(3)(4)(5)(6)(7)(8)(9). The suitability of plastic syringes for blood gas sampling has been investigated often during (2) on errors caused by severe leukocytosis and thromthe last two decades with controversial results (10-bocytosis at 4 °C and 22 °C (series III -VII).…”

Section: Introductionmentioning

confidence: 99%

Stability of pO 2 , pCO 2 and pH in Heparinized Whole Blood Samples: Influence of Storage Temperature with Regard to Leukocyte Count and Syringe Material

Schmidt

Müller‐Plathe²

1992

Clinical Chemistry and Laboratory Medicine

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Schmidt and M ller-Plathe: Stability of/?O 2 , pCO 2 and pH: Influence of storage temperature and blood cell metabolism 767 Eur. J. Clin. Chem. Clin. Biochem. Vol. 30, 1992, pp. 767-773 © 1992 Summary: Influences of storage temperature and blood cell metabolism in different types of syringes were investigated. Experiments were performed on blood samples with normal and elevated leukocyte counts. After equilibration with gas mixtures at normal pO 2 (86 mm Hg/11.5 kPa) and elevated pO 2 (140 mm Hg/18.7 kPa), sequential blood gas analyses were done within one hour. Storage temperatures were 4 °C or 22 °C.In the first group of experiments we compared glass samplers with plastic syringes at different storage temperatures with regard to deviations of blood gas concentrations. The analysed samples had a normal cell count. Blood stored in glass syringes in ice water served as the reference, and it displayed virtually no changes. The deviations of pCO 2 and pH were relatively small. In plastic syringes the greatest increases for pO 2 occurred after storage at 4 °C, which can be explained by the increased solubility of oxygen and the higher O 2 affinity of haemoglobin at 4 °C. When stored at room temperature, the deviations in plastic syringes were smaller.In a second group of experiments, the influence of cell metabolism was studied. Blood gases were analysed in samples with elevated leukocyte counts (20 χ 10 9

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Blood gas analysis: effect of air bubbles in syringe and delay in estimation.

Cited by 108 publications

References 7 publications

Application of a Novel Fiber-Optic Biosensor In Situ to Investigate the Metabolic Effect of Lactate Infusion

Application of a Novel Fiber-Optic Biosensor In Situ to Investigate the Metabolic Effect of Lactate Infusion

Instrumental variability of respiratory blood gases among different blood gas analysers in different laboratories

Stability of pO 2 , pCO 2 and pH in Heparinized Whole Blood Samples: Influence of Storage Temperature with Regard to Leukocyte Count and Syringe Material

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