scholarly journals A Retrospective Review of the Effect of COVID-19 Pandemic on Laboratory Utilization

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S112-S112
Author(s):  
O Olayinka ◽  
O Odujoko ◽  
S Barasch ◽  
J Farley ◽  
C Woodruff ◽  
...  
Keyword(s):  
Point Of Care ◽  
Clinical Pathology ◽  
Gas Analysis ◽  
Percentage Increase ◽  
Blood Gas ◽  
Test Volume ◽  
Substantial Impact ◽  
Laboratory Utilization ◽  
The Impact ◽  
D Dimer

Abstract Introduction/Objective We performed a retrospective analysis of test volumes in clinical pathology prior to and during the COVID-19 pandemic to better understand the impact of the pandemic on our laboratory utilization. Methods/Case Report The laboratory information system was queried for test order volume in 2019 and 2020 using Discern Analytics 2.0. Representative tests including C-reactive protein (CRP), D-dimer, fibrinogen, ferritin, lactate dehydrogenase (LDH), procalcitonin, prothrombin time (PT), point of care iSTAT blood gas analysis, ABO and Rhesus typing (ABORh), antibody screening, flow cytometry, and serum protein electrophoresis (SPEP). Data was analyzed using Microsoft Excel 2013. Results (if a Case Study enter NA) The data showed an increase in the number of tests ordered and verified in the in-patient setting. The increase was most substantial for D-dimer, CRP and LDH with a percentage increase of approximately 200% on each test from year 2019 to 2020. An increase of 73% and 57% was noted for ferritin and fibrinogen respectively. A slight decrease in volume was noted for tests ordered in the out-patient setting including SPEPs during the pandemic. There was no significant change in the number of orders verified for point of care ISTAT blood gas testing between 2019 and 2020. Procalcitonin test volume increased steadily from its implementation in May 2020 with a steep rise in test volume in November and December. A total of 75,295 SARS-CoV-2 molecular tests were ordered between March and December 2020 with approximately 80% of the orders being performed as a send- out test. Conclusion The COVID-19 pandemic has had a substantial impact on laboratory utilization with significant volume increases in tests that guide the management of hospitalized COVID-19 patients and slight decrease in tests ordered mostly in the outpatient setting. These results may help guide current and future decisions relating to laboratory operations during pandemics.

scholarly journals Be cautious during the interpretation of arterial blood gas analysis performed outside the intensive care unit

2020 ◽  
Author(s):  
Lukasz Krzych ◽  
Olga Wojnarowicz ◽  
Paweł Ignacy ◽  
Julia Dorniak
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Point Of Care ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Acid Base Balance ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
The Impact

Introduction. Reliable results of an arterial blood gas (ABG) analysis are crucial for the implementation of appropriate diagnostics and therapy. We aimed to investigate the differences (Δ) between ABG parameters obtained from point-of-care testing (POCT) and central laboratory (CL) measurements, taking into account the turnaround time (TAT). Materials and methods. A number of 208 paired samples were collected from 54 intensive care unit (ICU) patients. Analyses were performed using Siemens RAPIDPoint 500 Blood Gas System on the samples just after blood retrieval at the ICU and after delivery to the CL. Results. The median TAT was 56 minutes (IQR 39-74). Differences were found for all ABG parameters. Median Δs for acid-base balance ere: ΔpH=0.006 (IQR –0.0070–0.0195), ΔBEef=–0.9 (IQR –2.0–0.4) and HCO3–act=–1.05 (IQR –2.25–0.35). For ventilatory parameters they were: ΔpO2=–8.3 mmHg (IQR –20.9–0.8) and ΔpCO2=–2.2 mmHg (IQR –4.2––0.4). For electrolytes balance the differences were: ΔNa+=1.55 mM/L (IQR 0.10–2.85), ΔK+=–0.120 mM/L (IQR –0.295–0.135) and ΔCl–=1.0 mM/L (IQR –1.0–3.0). Although the Δs might have caused misdiagnosis in 51 samples, Bland-Altman analysis revealed that only for pO2 the difference was of clinical significance (mean: –10.1 mmHg, ±1.96SD –58.5; +38.3). There was an important correlation between TAT and ΔpH (R=0.45, p<0.01) with the safest time delay for proper assessment being less than 39 minutes. Conclusions. Differences between POCT and CL results in ABG analysis may be clinically important and cause misdiagnosis, especially for pO2. POCT should be advised for ABG analysis due to the impact of TAT, which seems to be the most important for the analysis of pH.

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

2020 ◽  
Vol 144 (10) ◽  
pp. 1209-1216
Author(s):  
Ana Laila Qasem Moreno ◽  
Paloma Oliver Sáez ◽  
Pilar Fernández Calle ◽  
Gloria del Peso Gilsanz ◽  
Sara Afonso Ramos ◽  
...  
Keyword(s):  
Point Of Care ◽  
Blood Gas Analysis ◽  
Turnaround Time ◽  
Gas Analysis ◽  
Economic Outcomes ◽  
Blood Gas ◽  
Point Of Care Testing ◽  
Total Cost ◽  
Elapsed Time ◽  
The Impact

Context.— 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. Objective.— 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. Design.— 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. Results.— 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. Conclusions.— The implementation of a point-of-care blood gas analysis in a nephrology department has a positive impact on clinical, operative, and economic terms of patient care.

StatPal II pH and Blood Gas Analysis System evaluated

1994 ◽  
Vol 40 (1) ◽  
pp. 124-129 ◽  
Author(s):  
R J Wong ◽  
J J Mahoney ◽  
J A Harvey ◽  
A L Van Kessel
Keyword(s):  
Point Of Care ◽  
Blood Gases ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Portable Instrument ◽  
Blood Gas ◽  
Target Value ◽  
Analysis System

Abstract We evaluated a new portable instrument, the PPG StatPal II pH and Blood Gas Analysis System, designed for "point-of-care" measurements of blood gases and pH. Inaccuracy (% of target value) and imprecision (CV%) were assessed by blood tonometry and comparison with a Corning 178. Within-day results for PCO2 inaccuracy and imprecision ranged from 98.2% to 102.9% and 3.3% to 3.9%, respectively; for PO2, these were 95.5% to 102.3% and 2.3% to 3.0%, respectively. Between-day results for PCO2 inaccuracy and imprecision ranged from 99.2% to 99.3% and from 2.9% to 3.2%, respectively; for PO2, the ranges were 96.2% to 98.2% and 2.6% to 3.0%, respectively. Two PCO2 outliers (in 645 samples = 0.3%) were observed. In general, tonometry recovery, measurement stability, and pH bias results for the StatPal II and Corning 178 were comparable. We conclude that the StatPal II performs within acceptable ranges of inaccuracy and imprecision.

scholarly journals Usefulness of Clinical Prediction Rules, D-dimer, and Arterial Blood Gas Analysis to Predict Pulmonary Embolism in Cancer Patients

2017 ◽  
Vol 32 (2) ◽  
pp. 148-153
Author(s):  
Asifa Karamat ◽  
Shazia Awan ◽  
Muhammad Ghazanfar Hussain ◽  
Fahad Al Hameed ◽  
Faheem Butt ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Clinical Prediction ◽  
Prediction Rules ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis ◽  
D Dimer

scholarly journals A paradigmatic case of haemolysis and pseudohyperkalemia in blood gas analysis

2018 ◽  
Vol 29 (1) ◽  
pp. 169-172
Author(s):  
Gian Luca Salvagno ◽  
Davide Demonte ◽  
Giuseppe Lippi
Keyword(s):  
Reference Range ◽  
Point Of Care ◽  
Venous Blood ◽  
Blood Gas Analysis ◽  
Plasma Potassium ◽  
Gas Analysis ◽  
Blood Gas ◽  
High Potassium ◽  
Plastic Tube ◽  
History Of

A 51-year old male patient was admitted to the hospital with acute dyspnea and history of chronic asthma. Venous blood was drawn into a 3.0 mL heparinized syringe and delivered to the laboratory for blood gas analysis (GEM Premier 4000, Instrumentation Laboratory), which revealed high potassium value (5.2 mmol/L; reference range on whole blood, 3.5-4.5 mmol/L). This result was unexpected, so that a second venous blood sample was immediately drawn by direct venipuncture into a 3.5 mL lithium-heparin blood tube, and delivered to the laboratory for repeating potassium testing on Cobas 8000 (Roche Diagnostics). The analysis revealed normal plasma potassium (4.6 mmol/L; reference range in plasma, 3.5-5.0 mmol/L) and haemolysis index (5; 0.05 g/L). Due to suspicion of spurious haemolysis, heparinized blood was transferred from syringe into a plastic tube and centrifuged. Potassium and haemolysis index were then measured in this heparinized plasma, confirming high haemolysis index (50; 0.5 g/L) and pseudohyperkalemia (5.5 mmol/L). Investigation of this case revealed that spurious haemolysis was attributable to syringe delivery in direct ice contact for ~15 min. This case emphasizes the importance of avoiding sample transportation in ice and the need of developing point of care analysers equipped with interference indices assessment.

23 NEONATAL SUPPORT THERAPY AND BLOOD GAS EVALUATION IN CLONED AND ARTIFICIAL INSEMINATION-DERIVED NEWBORN CALVES

2015 ◽  
Vol 27 (1) ◽  
pp. 104
Author(s):  
P. Fantinato-Neto ◽  
A. T. Zanluchi ◽  
M. M. Yasuoka ◽  
F. J. M. Marchese ◽  
J. R. V. Pimentel ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Point Of Care ◽  
Respiratory Acidosis ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Oxygenation ◽  
Blood Gas ◽  
Acid Base Balance ◽  
Reproductive Techniques ◽  
Newborn Calves

Offspring derived from artificial reproductive techniques are already known to present several postnatal undesirable phenotypes and clinical disorders. Despite its benefits, cloning by somatic cell nuclear transfer (SCNT) is extremely inefficient. The birth rate in cattle is around 5% of the transferred blastocysts, and ~50% of delivered calves die in the first 48 h. Neonatal respiratory distress is reported to be one of the main causes of such deaths. Veterinary intervention is often needed to promote or improve blood oxygenation, avoiding respiratory acidosis and improving carbon dioxide delivery from blood/lungs to the environment. This study aimed to evaluate a neonatal support therapy over the blood gas and acid-base balance on newborn calves derived from SCNT or AI. Four cloned and 3 AI-derived calves delivered by Caesarean section were used for the experiment. Postnatal therapeutic procedures were comprised 4 doses of 400 mg of intratracheal surfactant every 15 min, 25 mg of oral sildenafil every 8 h for 3 days, and 5 L min–1 intranasal oxygen. Blood collections were performed within 30 min (T0), at 12 (T12), 24 (T24) and 48 (T48) hours after delivery. Blood samples were collected from the caudal auricular artery with a butterfly and a blood gas syringe. Oxygen saturation (sO2), arterial pressure of oxygen (PaO2) and carbon dioxide (PaCO2), pH, and bicarbonate (HCO3–) were evaluated with a portable blood gas analyzer (i-STAT, Abbott Point of Care Inc., Princeton, NJ, USA). Data obtained were submitted to ANOVA (Proc MIXED; SAS/STAT, version 9; SAS Institute Inc., Cary, NC, USA). There were significant differences between groups in blood pH (P = 0.0182) and between groups (P = 0.0281) and time of collection (P = 0.0303) in blood bicarbonate (HCO3–). The AI calves were born with normal pH (7.468 ± 0.033) and the cloned calves were born in acidosis (7.216 ± 0.166). These calves were stabilised in T48 (7.427 ± 0.017) using their own HCO3– that increased over time. Although there were no differences in sO2 (P = 0.4525), PaO2 (P = 0.3086), or PaCO2 (P = 0.2514), sO2 and PaO2 were numerically increased at the same time that PaCO2 decreased in both groups. In the cloned calves, the sO2, PaO2, and PaCO2 at T0 were 61.3 ± 28.6%, 39.8 ± 18.5 mmHg, and 65.8 ± 29.3 mmHg, respectively and reached 90.0 ± 3.4%, 57.7 ± 15.8 mmHg, and 42.0 ± 3.7 mmHg. In the AI calves, T0 blood gas analysis were 79.8 ± 19.4%, 56.1 ± 42.1 mmHg, and 39.1 ± 4.8 mmHg, and at T48 were 89.0 ± 2.6%, 82.3 ± 43.5 mmHg, and 43.0 ± 4.9 mmHg for sO2, PaO2, and PaCO2 respectively. The neonate support therapy improved calves' oxygenation and helped to eliminate the carbon dioxide from the blood. In our experience, the neonatal treatment was essential in supporting the lives of the cloned calves.Funding support was received from FAPESP 2011/19543–9.

TO DETERMINE THE IMPACT OF BLOOD GAS ANALYSIS AND BICARBONATE ADMINISTRATION DURING IN-HOSPITAL CARDIOPULMONARY RESUSCITATION: A RETROSPECTIVE ANALYSIS

CHEST Journal ◽  
2009 ◽  
Vol 136 (4) ◽  
pp. 17S
Author(s):  
Kennedy K. Eneh ◽  
Zahir Mehjabin ◽  
Civunigunta Narendra ◽  
Rekha Khurana ◽  
Frances Schmidt ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Retrospective Analysis ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
The Impact
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