Comparison of point‐of‐care and central laboratory analyzers for blood gas and lactate measurements

Indrasari, Nuri Dyah; Wonohutomo, Jessica Purwanti; Sukartini, Ninik

doi:10.1002/jcla.22885

Cited by 18 publications

(15 citation statements)

References 9 publications

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“…With the widespread use of point‐of‐care testing, it has been possible to bring the use of some biomarkers such as blood lactate to the bedside 19 . The devices in question can be used to obtain lactate determinations with a minimally invasive procedure, in an economical, safe and fast way, and are validated for the hospital environment with results comparable to those of traditional analyses 20 …”

Section: Introductionmentioning

confidence: 99%

Can capillary lactate improve early warning scores in emergency department? An observational, prospective, multicentre study

et al. 2020

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Aims To determine the prognostic usefulness of the National Early Warning Score‐2 (NEWS2) and quick Sepsis‐related Organ Failure Assessment (qSOFA) scores, in isolation and combined with capillary lactate (CL), using the new NEWS2‐L and qSOFA‐L scores to predict the 30‐day mortality risk. Methods Prospective, multicentre and observational study in patients across four EDs. We collected sets of vital signs and CL and subsequently calculated NEWS2, qSOFA, NEWS2‐L and qSOFA‐L scores when patients arrived at the ED. The main outcome measure was all‐cause mortality 30 days from the index event. Results A total of 941 patients were included. Thirty‐six patients (3.8%) died within 30 days of the index event. A high CL level has not been linked to a higher mortality. The NEWS2 presented AUROC of 0.72 (95% CI: 0.62‐0.81), qSOFA of 0.66 (95% CI: 0.56‐0.77) (P < .001 in both cases) and CL 0.55 (95% CI: 0.42‐0.65; P = .229) to predict 30‐day mortality. The addition of CL to the scores analysed does not improve the results of the scores used in isolation. Conclusion NEWS2 and qSOFA scores are a very useful tool for assessing the status of patients who come to the ED in general for all types of patients in triage categories II and III and for detecting the 30‐day mortality risk. CL determined systematically in the ED does not seem to provide information on the prognosis of the patients.

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Section: Introductionmentioning

confidence: 99%

Can capillary lactate improve early warning scores in emergency department? An observational, prospective, multicentre study

et al. 2020

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“…These instruments have been validated for use in various species, and provide similar test menus including blood-gas, blood electrolyte (sodium [Na + ], potassium [K + ], chloride [Cl − ], ionized calcium [iCa 2+ ]) concentrations, and blood glucose, lactate, urea nitrogen (BUN), and creatinine concentrations. 6,8,[18][19][20] Although these instruments both use ISE measurement technology and amperometry, algorithmic and other qualities can result in variability in reported parameters between instruments.…”

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confidence: 99%

Evaluation of the i-STAT Alinity v in a veterinary clinical setting

et al. 2021

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Many point-of-care (POC) analyzers are available for the measurement of electrolytes and acid-base status in animals. We assessed the precision of the i-STAT Alinity v, a recently introduced POC analyzer, and compared it to 2 commonly used and previously validated POC analyzers (i-STAT 1, Stat Profile pHOx Ultra). Precision was evaluated by performing multiple analyses of whole blood samples from healthy dogs, cats, and horses on multiple i-STAT Alinity v analyzers. For comparison between analyzers, whole blood samples from dogs and cats presented to the emergency room were run concurrently on all 3 POC instruments. Reported values were compared by species (dogs and cats only) using Pearson correlation, and all values from all species were analyzed together for the Bland–Altman analysis. Results suggested that the i-STAT Alinity v precision was very good, with median coefficients of variability <2.5% for all measured parameters (except the anion gap), with variable ranges of coefficients of variation. In addition, good-to-excellent correlation was observed between the i-STAT Alinity v and i-STAT 1, and between the i-STAT Alinity v and Stat Profile pHOx Ultra for all parameters in both cats and dogs, respectively. In this cohort, the i-STAT Alinity v had clinically acceptable bias compared to the currently marketed analyzers and can be used for monitoring measured analytes in cats and dogs, although serial measurements in a single animal should be performed on the same analyzer whenever possible.

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“…The i-STAT (i-STAT Alinity, Abbott, Illinois, USA) is a point-of-care (POC) analyser that measures blood gases and electrolytes with ion-selective electrode potentiometry. The handheld device operates with single-use test cartridges (i-STAT Alinity Base station, Abbott), requires the application of two to three drops of blood in the cartridge, and can deliver results within minutes [ 18 ]. The system requires a temperature above 15 °C to operate [ 19 ].…”

Section: Methodsmentioning

confidence: 99%

Prehospital emergency medical technicians can perform ultrasonography and blood analysis in prehospital evaluation of patients with chronic obstructive pulmonary disease: a feasibility study

Nadim

Laursen

Pietersen

et al. 2021

BMC Health Serv Res

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Introduction Crowding of the emergency departments is an increasing problem. Many patients with an exacerbation of chronic obstructive pulmonary disease (COPD) are often treated in the emergency departments for a very short period before discharged to their homes. It is possible that this treatment could take place in the patients’ homes with sufficient diagnostics supporting the treatment. In an effort to keep the diagnostics and treatment of some of these patients in their homes and thus to reduce the patient load at the emergency departments, we implemented a prehospital treat-and-release strategy based on ultrasonography and blood testing performed by emergency medical technicians (EMT) or paramedics (PM) in patients with acute exacerbation of COPD. Method EMTs and PMs were enrolled in a six-hour educational program covering ultrasonography of the lungs and point of care blood tests. During the seasonal peak of COPD exacerbations (October 2018 – May 2019) all patients who were treated by the ambulance crews for respiratory insufficiency were screened in the ambulances. If the patient had uncomplicated COPD not requiring immediate transport to the hospital, ultrasonographic examination of the lungs, measurements of C-reactive protein and venous blood gases analyses were performed. The response to the initial treatment and the results obtained were discussed via telemedical consultation with a prehospital anaesthesiologist who then decided to either release the patient at the scene or to have the patient transported to the hospital. The primary outcome was strategy feasibility. Results We included 100 EMTs and PMs in the study. During the study period, 771 patients with respiratory insufficiency were screened. Uncomplicated COPD was rare as only 41patients were treated according to the treat-and-release strategy. Twenty of these patients (49%) were released at the scene. In further ten patients, technical problems were encountered hindering release at the scene. Conclusion In a few selected patients with suspected acute exacerbations of COPD, it was technically and organisationally feasible for EMTs and PMs to perform prehospital POCT-ultrasound and laboratory testing and release the patients following treatment. None of the patients released at the scene requested a secondary ambulance within the first 48 h following the intervention.

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Comparison of point‐of‐care and central laboratory analyzers for blood gas and lactate measurements

Cited by 18 publications

References 9 publications

Can capillary lactate improve early warning scores in emergency department? An observational, prospective, multicentre study

Can capillary lactate improve early warning scores in emergency department? An observational, prospective, multicentre study

Evaluation of the i-STAT Alinity v in a veterinary clinical setting

Prehospital emergency medical technicians can perform ultrasonography and blood analysis in prehospital evaluation of patients with chronic obstructive pulmonary disease: a feasibility study

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