Clinical, Operative, and Economic Outcomes of the Point-of-Care Blood Gases in the Nephrology Department of a Third-Level Hospital

Abstract

<jats:sec><jats:title>Context.—</jats:title><jats:p> Point-of-care testing allows rapid analysis and short turnaround times. To the best of our knowledge, the present study assesses, for the first time, clinical, operative, and economic outcomes of point-of-care blood gas analysis in a nephrology department. </jats:p></jats:sec><jats:sec><jats:title>Objective.—</jats:title><jats:p> To evaluate the impact after implementing blood gas analysis in the nephrology department, considering clinical (differences in blood gas analysis results, critical results), operative (turnaround time, elapsed time between consecutive blood gas analysis, preanalytical errors), and economic (total cost per process) outcomes. </jats:p></jats:sec><jats:sec><jats:title>Design.—</jats:title><jats:p> A total amount of 3195 venous blood gas analyses from 688 patients of the nephrology department before and after point-of-care blood gas analyzer installation were included. Blood gas analysis results obtained by ABL90 FLEX PLUS were acquired from the laboratory information system. Statistical analyses were performed using SAS 9.3 software. </jats:p></jats:sec><jats:sec><jats:title>Results.—</jats:title><jats:p> During the point-of-care testing period, there was an increase in blood glucose levels and a decrease in pCO2, lactate, and sodium as well as fewer critical values (especially glucose and lactate). The turnaround time and the mean elapsed time were shorter. By the beginning of this period, the number of preanalytical errors increased; however, no statistically significant differences were found during year-long monitoring. Although there was an increase in the total number of blood gas analysis requests, the total cost per process decreased. </jats:p></jats:sec><jats:sec><jats:title>Conclusions.—</jats:title><jats:p> The implementation of a point-of-care blood gas analysis in a nephrology department have a positive impact on clinical, operative, and economic terms of patient care. </jats:p></jats:sec>

Use of point-of-care glucometers during an oral glucose tolerance test in children for prediabetes and diabetes diagnosis: a comparison study

“…The significant decrease in TAT when only POCT devices are used has already been demonstrated in numerous clinical settings [ 7 , 9 , 16 ]. In our investigation, not only each glucose measurement improved considerably its TAT but also OGTT by POCT ACI , an important finding because the results are immediately available, allowing clinicians to make decisions after the OGTT and avoiding the need for additional patient visits.…”

“…As we have been performed in other contexts previously [ 7 ], [ 8 ], [ 9 ], we aimed to evaluate the technical accuracy and clinical concordance of POCT glucometers during OGTT on pediatric patients. It was evaluated considering the following objectives: glycaemia correlation, the progression of glucose measurements during OGTT, the turnaround time (TAT), diagnostic concordance and costs.…”

Quality Assessment of the Creatinine and Electrolytes Measurement in the Emergency Department

“…8 Previous reports suggest that the screening of patients at high risk of AKI is feasible with point-ofcare Cr testing in the emergency department or ICU. Moreno and colleagues 9 described the positive impact of the implementation of point-of-care blood gas analysis in a nephrology department on the clinical, operative, and economic aspects of patient care. However, the same paper reported significant differences in pCO2 and in Na ＋ , glucose, and lactate concentrations between point-of-care blood gas analysis and laboratory testing.…”

“…However, there is also a significant difference between the two, and in non-emergency situations, the central laboratory measurements should be recommended. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] Whether the difference between the Cr and electrolyte values measured by the blood gas analyzer and the values measured in the central laboratory is high or low depends on the medical institution. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] This difference is considered to be due to the measurement equipment, reagent, and environment.…”

“…7 Frequent measurement of Cr by POCT has been suggested as a simple, inexpensive, and easy predictive test for diagnosis of AKI in ICUs 8 and nephrology departments. 9 These measurements require the use of a blood gas analyzer to measure circulating Cr concentrations for rapid kidney function assessment. Since whole-blood samples are used for blood gas analysis, as a POCT, it can be analyzed immediately after blood collection.…”