May hemoglobin measurement by blood gas analyzer lead to severe adverse clinical consequences? Reply to letter to the editor

Introduction: Electrolyte and hemoglobin measurement are the integral part of management of critically ill patient. There can be a wide variation in the electrolyte and hemoglobin measurement in critically ill patient between arterial blood gas analyzer and central laboratory auto analyzer. Objective: To compare the electrolytes (sodium, potassium and chloride) and hemoglobin level measured by arterial blood gas analyzer and laboratory analyzer. Methodology: This was a prospective cross-sectional comparative study comparing the electrolytes (sodium, potassium and chloride) and hemoglobin measurement between arterial blood gas analyzer and laboratory auto analyzer. The study included 124 paired blood samples from the patient admitted in intensive care unit of Birat Medical College Teaching Hospital in two months duration. The arterial sample and venous sample for electrolytes and hemoglobin measurement were taken simultaneously or not more than one hour apart and analysis was done by arterial blood gas analyzer and central laboratory auto analyzer accordingly. The values of electrolytes and hemoglobin measured by two different analyzers were finally compared for variation. Result: The mean difference calculated for sodium potassium and chloride in ABG machine and Auto-analyzers were 0.57 mmol/l.-0.04mmol/l and 1.71mmol/l respectively. These data were within the acceptable range of United States Clinical Laboratory Improvement Amendments(USCLIA). The mean difference derived for hemoglobin in ABG and Auto-analyzers was 0.16g/dl which was not consistent with the range of United States Clinical Laboratory Improvement Amendments (USCLIA) Conclusion: The measurement of electrolyte namely sodium, potassium and chloride in ABG machines and Auto-analyzers of central lab were comparable while hemoglobin was not comparable under the USCLIA guidelines.

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Discordant Hemoglobin Values Determined by Blood Gas Analyzer and Hematology Analyzer Synchronously Is a Warning for Inappropriate Blood Sampling

Indian Journal of Clinical Biochemistry ◽

10.1007/s12291-020-00938-x ◽

2021 ◽

Author(s):

Özgür Aydın

Keyword(s):

Blood Sampling ◽

Blood Gas ◽

Gas Analyzer ◽

Hematology Analyzer ◽

Blood Gas Analyzer

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Use of a Sodium Chloride—Phosphate Buffer for pH Standardization in a New Blood-Gas Analyzer with an Isotonic Sodium Chloride Bridge

Clinical Chemistry ◽

10.1093/clinchem/19.11.1243 ◽

1973 ◽

Vol 19 (11) ◽

pp. 1243-1247 ◽

Cited By ~ 1

Author(s):

P A Drinker ◽

D C Noonan ◽

N Ramanaiah ◽

J R Tole

Keyword(s):

Sodium Chloride ◽

Blood Gas ◽

Gas Analyzer ◽

Liquid Junction ◽

Isotonic Sodium Chloride ◽

Salt Depletion ◽

The Stability ◽

Conventional Scheme ◽

Blood Gas Analyzer ◽

Junction Potential

Abstract Two different blood-gas analyzers were tested to determine the effects on blood pH measurement of changing the reference bridge solution from saturated KCl to normal saline (0.16 mol of NaCl per liter). This change, which necessitated the preparation of modified buffers equimolal in NaCl with respect to blood, virtually eliminated salt depletion of the bridge solution and improved the stability of the liquid-junction potential between the bridge solution and the sample. The instruments we used were the Corning 165 pH Blood Gas Analyzer and the Radiometer E5021 pH Electrode with PHM72 Acid Base Analyzer. Comparison of results on clinical blood samples indicates that performance with the modified bufferbridge system is the same as that obtained with the conventional scheme. Analytical performances of the Corning and Radiometer instruments for PO2 and PCO2, as well as for pH, were comparable.

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