How reliable are electrolyte and metabolite results measured by a blood gas analyzer in the ED?

Uysal, Ersin; Acar, Yahya Ayhan; Kutur, Ahmet; Cevik, Erdem; Salman, Necati; Tezel, Onur

doi:10.1016/j.ajem.2015.11.025

Cited by 15 publications

(19 citation statements)

References 17 publications

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“…Therefore, increasing the concentration of heparin and sodium increases errors in arterial blood parameters especially electrolytes. The increase in the combined effect of liquid heparin on electrolytes such as Ca, Mg, K in the presence of sodium has been described (14,16). Therefore, with the presence of higher concentrations of heparin, it is expected that sodium levels are reduced and the amounts of other electrolytes such as potassium and calcium are increased, which is also well-documented in terms of clinical significance.…”

Section: Discussionmentioning

confidence: 94%

Comparison of the effects of heparin 1000 and 5000 units on arterial blood gases

Borabadi¹,

Rad²,

Hassan³

et al. 2020

Acta fac medic Naissensis

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Analysis of arterial blood gases is necessary for managing the respiratory and metabolic parameters of patients in the intensive care unit. The aim of this study was to compare the effects of heparin 1000 and heparin 5000 units on arterial blood gases in patients admitted to the intensive care unit. This study was a triple-blinded clinical trial. A total of 78 patients with head injury were randomly selected from the emergency department of a hospital in an urban area of Iran in 2017. Data was collected using a questionnaire and a checklist of laboratory parameters. Data was analyzed using descriptive and inferential statistical methods via the R software. Statistically significant differences in Na, SaO2, Ca, BEecf (p < 0.001), and HCO3, BEe and K were observed between the two groups (p < 0.01). No statistically significant difference between the values of PaCO2, PH and PaO2 in the two groups were reported (p > 0.05). The results of this study confirmed that heparin 1000 and heparin 5000 units had no effects on respiratory parameters in analyzing arterial blood gases. However, the concentration of heparin had a significant effect on metabolic parameters for the analysis of arterial blood gases and electrolytes.

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Section: Discussionmentioning

confidence: 94%

Comparison of the effects of heparin 1000 and 5000 units on arterial blood gases

Borabadi¹,

Rad²,

Hassan³

et al. 2020

Acta fac medic Naissensis

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“…A POCT device that is capable of a real-time blood test in the ED has been reported in the literature [ 13 – 15 ]. The device has the potential to provide quick identification of a patient’s condition based on the results.…”

Section: Discussionmentioning

confidence: 99%

Initial blood pH during cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients: a multicenter observational registry-based study

et al. 2017

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BackgroundWhen an out-of-hospital cardiac arrest (OHCA) patient receives cardiopulmonary resuscitation (CPR) in the emergency department (ED), blood laboratory test results can be obtained by using point-of-care testing during CPR. In the present study, the relationship between blood laboratory test results during CPR and outcomes of OHCA patients was investigated.MethodsThis study was a multicenter retrospective analysis of prospective registered data that included 2716 OHCA patients. Data from the EDs of three university hospitals in different areas were collected from January 2009 to December 2014. Univariate and multivariable analyses were conducted to elucidate the factors associated with survival to discharge and neurological outcomes. A final analysis was conducted by including patients who had no prehospital return of spontaneous circulation and those who underwent rapid blood laboratory examination during CPR.ResultsOverall, 2229 OHCA patients were included in the final analysis. Among them, the rate of survival to discharge and a good Cerebral Performance Categories Scale score were 14% and 4.4%, respectively. The pH level was independently related to survival to hospital discharge (adjusted OR 6.287, 95% CI 2.601–15.197; p < 0.001) and good neurological recovery (adjusted OR 15.395, 95% CI 3.439–68.911; p < 0.001). None of the neurologically intact patients had low pH levels (< 6.8) or excessive potassium levels (> 8.5 mEq/L) during CPR.ConclusionsAmong the blood laboratory test results during CPR of OHCA patients, pH and potassium levels were observed as independent factors associated with survival to hospital discharge, and pH level was considered as an independent factor related to neurological recovery.

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“…However, controversy remains over the agreement between the results obtained from blood gas analysers and laboratory auto-analysers for haematological and biochemical parameters. [1][2][3][4][5][6][7] There are many differences between blood gas and laboratory auto-analysers, particularly in terms of measurement of individual parameters and measurement error. Blood gas analysers use direct ion-selective electrodes, whereas most laboratory biochemistry autoanalysers use indirect ion-selective electrodes.…”

Section: Introductionmentioning

confidence: 99%

Can the blood gas analyser results be believed? A prospective multicentre study comparing haemoglobin, sodium and potassium measurements by blood gas analysers and laboratory auto-analysers

Triplett

Wibrow

Norman

et al. 2019

Anaesth Intensive Care

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Blood gas analysers are point-of-care testing devices used in the management of critically ill patients. Controversy remains over the agreement between the results obtained from blood gas analysers and laboratory auto-analysers for haematological and biochemistry parameters. We conducted a prospective analytical observational study in five intensive care units in Western Australia, in patients who had a full blood count (FBC), urea, electrolytes and creatinine (UEC), and a blood gas performed within 1 h of each other during the first 24 h of their intensive care unit admission. The main outcome measure was to determine the agreement in haemoglobin, sodium, and potassium results between laboratory haematology and biochemistry auto-analysers and blood gas analysers. A total of 219 paired tests were available for haemoglobin and sodium, and 215 for potassium. There was no statistically significant difference between the results of the blood gas and laboratory auto-analysers for haemoglobin (mean difference –0.35 g/L, 95% confidence interval (CI) –1.20 to 0.51, P = 0.425). Although the mean differences between the two methods were statistically significant for sodium (mean difference 1.49 mmol/L, 95% CI 1.23–1.76, P < 0.0001) and potassium (mean difference 0.19 mmol/L, 95% CI 0.15–0.24, P < 0.0001), the mean biases on the Bland–Altman plots were small and independent of the magnitude of the measurements. The two methods of measurement for haemoglobin, sodium and potassium agreed with each other under most clinical situations when their values were within or close to normal range suggesting that routine concurrent blood gas and formal laboratory testing for haemoglobin, sodium and potassium concentrations in the intensive care unit is unwarranted.

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How reliable are electrolyte and metabolite results measured by a blood gas analyzer in the ED?

Cited by 15 publications

References 17 publications

Comparison of the effects of heparin 1000 and 5000 units on arterial blood gases

Comparison of the effects of heparin 1000 and 5000 units on arterial blood gases

Initial blood pH during cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients: a multicenter observational registry-based study

Can the blood gas analyser results be believed? A prospective multicentre study comparing haemoglobin, sodium and potassium measurements by blood gas analysers and laboratory auto-analysers

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