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.

High altitude arterialised capillary earlobe blood gas measurement using the Abbott i-STAT

2018 ◽  
Vol 164 (5) ◽  
pp. 335-337 ◽  
Author(s):  
Christopher T Lewis ◽  
W L Malein ◽  
I Chesner ◽  
S Clarke
Keyword(s):  
Partial Pressure ◽  
High Altitude ◽  
Point Of Care ◽  
Extreme Environments ◽  
Blood Gases ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Clinical Environment ◽  
Gas Measurements

IntroductionMeasurement of physiological parameters in extreme environments is essential to advancing knowledge, prophylaxis and treatment of altitude sickness. Point-of-care testing facilitates investigation in non-specialist and remote settings, as well as becoming increasingly popular at the bedside for real-time results in the clinical environment. Arterialised capillary earlobe blood gases are recommended as a valid alternative to arterial sampling in research. This study aimed to test the feasibility of obtaining and analysing daily earlobe samples at high altitude.MethodsFrom 17 to 24 January 2016, 24 participants on a research expedition to Ecuador underwent daily earlobe blood gas measurements including pH, partial pressure of oxygen and partial pressure of carbon dioxide to 5043 m. Samples were analysed using an Abbott i-STAT blood gas analyser and G3+ cartridges.ResultsDaily measurements were successfully obtained and analysed at the point of care in 23/24 participants and were well tolerated with no adverse events. 12% (27/220) cartridges failed and required repeat sampling.ConclusionsDaily earlobe blood gas analysis using the Abbott i-STAT is feasible in a protected environment at high altitude. Participants and equipment should be kept warm before and during testing. Spare cartridges should be available. This methodology may be useful for both research and therapeutic measurements in remote, rural and wilderness medicine.

scholarly journals Evaluation of the i-STAT Blood Gas Analysis System in Cardiovascular Surgery

2018 ◽  
Vol 4 (2) ◽  
pp. 35
Author(s):  
Çiğdem Unal Kantekin ◽  
Müjgan Ercan ◽  
Esra Firat Oğuz ◽  
Ertan Demirdaş ◽  
Kıvanç Atılgan ◽  
...  
Keyword(s):  
Cardiovascular Surgery ◽  
Point Of Care ◽  
Artery Bypass ◽  
Blood Gas Analysis ◽  
Clinical Decision ◽  
Gas Analysis ◽  
Internal Quality ◽  
Blood Gas ◽  
Control Programs ◽  
Analysis System

The aim of this study was toinvestigate the compatibility of the parameters measured with the i-STAT blood gas analyser and the conventional blood gas analyser Rapid Point 500 (Siemens Healthcare Diagnostics, USA) in patients who underwent cardiovascular surgery. This clinical study included fifty patients undergoing coronary artery bypass surgery. Fifty whole blood samples were portioned and measured on the i-STAT and RP500 laboratory analyzers. The compatibility between pH, pCO2, pO2, Hb, Na+, K+, iCa2+ and glucose values was investigated.There was a good correlation of the i-STAT analyser with the RP500 analyser, with the exception Hb and Na+. Also all parameters except for Hb and ionized calcium were found to be within acceptable range in terms of clinical decision limits. It is very important that the point-of-care devices give accurate results as well as quick results. For this reason, we absolutely think that the point of care devices should be subjected to external and internal quality control programs, users should be trained regularly and feedback studies should be done.

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 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.

Blood Gas Analysis and the Fundamentals of Acid-Base Balance

2009 ◽  
Vol 28 (2) ◽  
pp. 125-128 ◽  
Author(s):  
Mary Farmand
Keyword(s):  
Systematic Approach ◽  
Blood Gases ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Acid Base Balance ◽  
Bedside Nurse ◽  
Acid Base ◽  
Neonatal Nursing ◽  
Base Balance

UNDERSTANDING BLOOD GAS values and acid-base balance are fundamental skills of neonatal nursing. This is because, in the NICU, blood gases are probably ordered more than any other laboratory test. The bedside nurse not only obtains the specimen, but is also crucially involved in interpreting the results because blood gases cannot stand alone; they need to be evaluated in the context of the entire clinical picture. This article provides basic information on the components of a blood gas, acid-base balance, as well as a systematic approach to blood gas analysis.

scholarly journals Gestation in a Mare with Facial Deviation (Wry Nose)

2019 ◽  
Vol 47 ◽  
Author(s):  
Mariana Andrade Mousquer ◽  
Vitória Müller ◽  
Fernanda Maria Pazinato ◽  
Bruna Dos Santos Suñe Moraes ◽  
Leandro Américo Rafael ◽  
...  
Keyword(s):  
Fetal Development ◽  
Post Partum ◽  
Venous Blood ◽  
Respiratory Acidosis ◽  
Blood Gases ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Aorta Diameter ◽  
Uterine Body

Background: Wry nose is a congenital deformity that causes respiratory obstruction and decreased oxygenation rate. Gestation in a wry nose mare may be considered a risk to the neonate since it depends on the maternal environment for development. Compromised oxygenation during pregnancy can lead to fetal distress and cause consequences on fetal development. However, depending on the degree of the impairment, the fetus may still be able to adapt. The aim of the present study was to report the gestation in a mare with facial deviation until term and to assess blood gases in the mare and neonate, and to evaluate the histomorphometry of the placenta.Case: A Criollo breed mare presenting facial deviation (Wry Nose) was donated to Equine Medicine Research Group (ClinEq) of the Federal University of Pelotas (UFPel) due to the presence of the physical deformity. When the mare was five years old, it was inseminated and had a pregnancy confirmed. At the fifth month of gestation, evaluation of fetal aorta diameter, fetal orbital diameter and combined thickness of the uterus and placenta (CTUP) started to be performed monthly to assess gestation health. The assessment of the fetal orbit and aorta diameter revealed a linear increase of both variables with the progress of gestation indicating a normal fetal development.  CTUP remained in the normal reference range, presenting no alterations during the gestational length. The mare foaled at 324 days of gestation a coat showing no congenital deformities. The foaling was monitored until the complete passage of fetal membranes. A complete clinical and hematological evaluation of the foal was carried out after birth. The foal showed normal adaptive behavior, clinical and hematological parameters during the first hours of life, although presenting physical signs of immaturity. Venous blood samples were collected from the mare at 315 days of gestation, immediately after foaling and 24 h post-partum for lactate and blood gas analysis.  Mild changes were observed in the mare’s blood gas analysis at foaling that were compensated within 24 h post-partum. Venous blood samples were collected from the umbilical cord and from the foal after birth, at 12 and 24 h post-partum to measure blood gases and lactate. The newborn foal presented respiratory acidosis immediately after birth, which was metabolically compensated at 24 h post-partum. Both mare’s and foal’s lactate evaluation were within the normal reference ranges. After expulsion of the placenta, samples from the gravid horn, uterine body and non-gravid horn were collected for histological and histomorphometric evaluation. In the histological evaluation, avillous areas were detected in the gravid horn and uterine body and mild hypoplasia was found in the uterine body. Placental histomorphometry revealed larger total microcotiledonary and capillary areas on the non-gravid horn when compared to the remaining areas of the placenta (gravid horn and uterine body). No abnormalities on the placental vasculature were detected.  Discussion: To date, there are no reports of a pregnancy in a mare with facial deviation in the literature. This report showed that the wry nose mare gave birth to a viable foal showing no congenital abnormalities, which suggests that wry nose animals can be bred normally. The mare presented a healthy pregnancy, with mild changes in the blood gas analysis at foaling that were compensated at 24 h postpartum. Similarly, despite the foal showed physical signs of immaturity and respiratory acidosis at birth, these changes were compensated in the later assessments. Furthermore, no abnormalities on the placental vasculature were detected.

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.

scholarly journals Can venous blood gas be a reliable substitute for arterial blood gases in modern clinical practice?

2019 ◽  
Vol 6 (4) ◽  
pp. 1016
Author(s):  
Sabiha Naz ◽  
Kiran Chugh ◽  
Isha Malik
Keyword(s):  
Venous Blood ◽  
Blood Gases ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
P Value ◽  
Emergency Setting ◽  
Blood Gas ◽  
Arterial Blood Gases ◽  
Arterial Blood ◽  
Venous Blood Gas

Background: It is clearly mentioned in the medicine books that blood gas analysis from arterial puncture is the gold standard. But in the past few years it is commonly seen that clinicians have started trusting on venous blood gas analysis as well as started advising VBG (Venous blood gas) in the initial diagnosis of critical patients in emergency setting. Keeping this fact in mind, we designed a study to determine whether VBG could be a better replacement of ABG (Arterial blood gases) in the emergency where diverse pathological conditions are encountered.Methods: This prospective cross-sectional study comprised of 50 patients of 20-60 yrs age with a variety of diagnoses admitted in the emergency department. 50 paired samples (ABG+VBG) were obtained from them under strict aseptic precautions after obtaining their verbal consent. With a minimum delay of less than 2 min blood gas analysis was performed on blood gas analyzer. Parameters (pH, PCO2, PO2, HCO3, Base Excess and O2 saturation) from ABG and VBG were recorded and compared using Student’s Unpaired ‘t’ test.Results: pH and HCO3 showed statistical significant (p value <0.05) differences between ABG and VBG, while BE showed statistical non-significant (p value >0.05) difference between them. Contrary to this, PCO2, PO2 and O2 saturation from ABG and VBG showed statistical highly significant (p value <0.0001) differences.Conclusions: VBG should not be interchangeably considered in place of ABG with regard to pH, HCO3, PCO2, PO2 and O2 saturation in conditions where actual oxygenation status of patient is required (e.g.; hypovolemic shock, respiratory disorders, mechanically ventilated patients, etc.)

scholarly journals Why hemolysis detection should be an integral part of any near-patient blood gas analysis

2021 ◽  
Vol 45 (4-5) ◽  
pp. 193-195
Author(s):  
Martin Möckel ◽  
Peter B. Luppa
Keyword(s):  
Point Of Care ◽  
Blood Gas Analysis ◽  
Routine Care ◽  
Gas Analysis ◽  
Blood Gas ◽  
Acid Base Balance ◽  
Acute Medicine ◽  
Delayed Treatment ◽  
Quality Aspects ◽  
Base Balance

Abstract Blood gas analysis at or near the patient’s bedside is a common practice in acute medicine and plays a crucial role in the diagnosis and management of patient’s respiratory status, metabolites, electrolytes, co-oximetry and acid–base balance. Pre-analytical quality aspects of the specimens are getting more and more attention, including the presence of potential interferences. Central laboratories have implemented technologies to detect interferences such as hemolysis, lipidemia or hyperbilirubinemia in blood samples to ensure the highest possible quality in results provided to routine care. However, systematic detection for interference due to hemolysis is currently not in place for blood gas analysis at the point-of-care (POC). To apply hemolysis detection solutions at the central laboratory, but not at the POC for blood gas analysis, is a clear contradiction when novel hemolysis detecting technologies are available. The introduction of a system that systematically detects hemolysis in connection to POC blood gas analysis would be imperative to patient safety and costs associated with potential clinical malpractice (leading to wrong, missing and/or delayed treatment) and would also ensure better compliance to CLSI guidelines and ISO standards, and be beneficial for patient and staff.

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