scholarly journals A Written Guideline Implementation Can Lead to Reductions in Laboratory Testing in an Intensive Care Unit

1997 ◽  
Vol 25 (1) ◽  
pp. 33-37 ◽  
Author(s):  
S. M. Mehari ◽  
J. H. Havill ◽  
C. Montgomery
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Laboratory Testing ◽  
Cost Savings ◽  
Blood Gases ◽  
Arterial Blood Gases ◽  
Blood Tests ◽  
Arterial Blood ◽  
The Impact

The impact of developing guidelines for laboratory testing in an Intensive Care Unit (ICU) was examined. Targeted blood tests were recorded on fifty cardiac surgery and fifty general intensive care patients retrospectively. Following the introduction of guidelines, the study was repeated with prospective data collection. Comparison of the samples before and after the intervention showed a 25.9% reduction in all blood tests and a 17.1% reduction in arterial blood gases in the post cardiac surgery group. In general ICU patients, the drop in all tests was 16.6% and in arterial blood gases 21.9%. The cost savings from the cardiac surgery sample was N.Z.$3,637 and general ICU N.Z.$3,166, giving a sum total of N.Z.$6,803 in 100 patients. The potential cost savings for the annual admissions of 1,200 patients is N.Z.$81,636. This study shows that written guidelines can bring about major cost reduction in the short-term.

scholarly journals Mean difference of Electrolyte Level measured in Arterial Blood gases and measured in Laboratory in Children presenting in Pediatric Intensive Care Unit

2021 ◽  
pp. 3-6
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Blood Gases ◽  
P Value ◽  
Arterial Blood Gases ◽  
K Value ◽  
Electrolyte Level ◽  
Arterial Blood

Background: Electrolytes are measured in arterial and venous blood by arterial blood gas analyzer and the auto-analyzers respectively. Objective: To determine the mean difference in electrolyte level in arterial blood gases (ABGs) level versus laboratory serum electrolyte level in the children admitted in the pediatric intensive care unit. Methodology: This cross-sectional study was conducted at department of Pediatrics, the Children’s Hospital and Institute of Child Health, Lahore from 1st December 2015 to 31st May 2016. Total of 125 children fulfilling inclusion criteria were enrolled in the study from pediatric intensive care unit. The ABGs (whole blood) electrolytes were obtained immediately after collection, using ABGs analyzer. Serum electrolytes were analyzed in the central laboratory of the institution. Reports were assessed and levels of sodium and potassium was noted from reports of ABGs and laboratory. Results: Mean NA+ value on ABGs and from laboratory was 134.66 and 132.26 (p= 0.01). Mean K+ value from on ABGs and from laboratory was 4.51 and 4.28. (p= 0.071). In age group 1-5 and 6-10 years, K+ level was high in ABGs value (p-value=0.065 & p-value=0.073). However, in age group 11-15 years K+ level was significantly higher in ABGs value as that of laboratory value (p-value=0.014). The same trend was observed in male and female children that mean NA+ and K+ value with ABGs was significantly higher as compared to that of laboratory value. Conclusion: NA+ and K+ in arterial blood gases level were different from laboratory serum electrolyte level in children admitted to pediatric intensive care unit. Clinician should be aware of differences so that potential misdiagnosis does not occur and unnecessary treatment or investigation can’t be performed.

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

2020 ◽  
Vol 37 (3) ◽  
pp. 267-273
Author(s):  
Reza Borabadi ◽  
Mostafa Rad ◽  
Mohammad Rakhshani ◽  
Mojtaba Rad
Keyword(s):  
Clinical Trial ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Gases ◽  
Metabolic Parameters ◽  
Arterial Blood Gases ◽  
R Software ◽  
Arterial Blood ◽  
Respiratory Parameters ◽  
Significant Difference

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.

The addition of haloperidol, propofol, or midazolam to sufentanil for intravenous sedation in the intensive care unit using bispectral index

2018 ◽  
Vol 4 (1) ◽  
pp. 34 ◽  
Author(s):  
Baris Tukenmez, MD ◽  
Dilek Memis, MD ◽  
Zafer Pamukcu, MD
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Bispectral Index ◽  
Biochemical Parameters ◽  
Blood Gases ◽  
Arterial Blood Gases ◽  
Infusion Group ◽  
Arterial Blood ◽  
Midazolam Infusion ◽  
Short Period

Aim: Inadequate sedative techniques may adversely affect morbidity and mortality in the intensive care unit (ICU), and the search for the ideal sedative agent continues. Combinations of hypnotics and opiates have are commonly used for sedation. In this study, the authors aimed to assess whether or not the addition of a haloperidol, propofol, or midazolam infusion decreased the sufentanil requirements by using bispectral index (BIS).Material and Methods: The study involved 60 patients in the ICU. All patients received 0.5 μg/kg sufentanil IV bolus. Immediately after, group S received 0.25 μg/kg sufentanil infusion, group SH received sufentanil infusion + haloperidol 3 mg/h infusion, group SP received sufentanil infusion + propofol 25 μg/kg/min infusion, and group SM received sufentanil infusion + midazolam 0.04 mg/kg/h infusion, for 6 hours. Average BIS values 61-80 and Ramsay Sedation Score 2-5 were kept at a range of by decreasing or increasing sufentanil levels in all groups and hourly sufentanil consumption was determined. Hemodynamic and biochemical parameters and arterial blood gases were determined at baseline and were repeated in study hours. Results: There was no significant difference in hemodynamic and biochemical parameters and arterial blood gases among the groups. Propofol, midazolam, haloperidol infusion, when added to sufentanil infusion, decreased the consumption of sufentanil in all the measured times (p < 0.001).Conclusions: The authors aimed to determine the effects of haloperidol, propofol, or midazolam infusion when added to sufentanil infusion in a short period of time. The authors found that propofol, midazolam, and haloperidol infusion decreased the sufentanil requirements in ICU patients.

scholarly journals Intoxication due toPapaver rhoeas(Corn Poppy): Five Case Reports

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Yahya Kemal Günaydın ◽  
Zerrin Defne Dündar ◽  
Bora Çekmen ◽  
Nazire Belgin Akıllı ◽  
Ramazan Köylü ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Physical Examination ◽  
Emergency Room ◽  
Female Patient ◽  
Blood Gases ◽  
Arterial Blood Gases ◽  
Papaver Rhoeas ◽  
Arterial Blood

Introduction. In this paper, we aimed to present fivePapaver rhoeasintoxication cases, which is very rare in the literature.Case 1. A 35-year-old female patient was admitted to our emergency room with the complaints of nausea, restlessness, and dyspnea developing 3 hours after eatingPapaver rhoeas. On physical examination, her general condition was moderate; she was conscious and the vital findings were normal. The pupils were myotic. She was transferred to the toxicology intensive care unit as she experienced a generalized tonic clonic seizure lasting for three minutes.Case 2. A 41-year-old female patient was brought to our emergency room by 112 ambulance as she had contractions in her arms and legs, unconsciousness, and foam coming from her mouth two hours afterPapaver rhoeasingestion. On physical examination, she was confused, the pupils were myotic, and she was tachycardic. Arterial blood gases analysis revealed lactic acidosis.Case 3. A 38-year-old female patient was admitted to our emergency room with complaints of nausea and vomiting two hours after ingestion ofPapaver rhoeas. Her physical examination and tests were normal.Case 4. A 34-year-old male patient was admitted to our emergency room with complaints of numbness and loss of power in his arms and legs one hour afterPapaver rhoeasingestion. He was hospitalized at the toxicology intensive care unit for follow-up and treatment. Dyspnea and bradycardia developed on the follow-up. The oxygen saturation without oxygen support was 90%. ECG revealed sinus bradycardia. The cardiac enzymes did not increase.Case 5. A 42-year-old female patient was brought to our emergency room by 112 ambulance with contractions in her arms and legs and unconsciousness two hours afterPapaver rhoeasingestion. On her physical examination, she was confused and the pupils were myotic. Arterial blood gases analysis revealed lactic acidosis.Conclusion. All patients were followed up for a few days and then discharged from the hospital with recovery. Unconscious consumption ofPapaver rhoeasleads to a clinical condition resembling morphine intoxication, CNS depression, and epileptic seizures.

Drs. Pierson and Bierman Reply

PEDIATRICS ◽  
1975 ◽  
Vol 56 (1) ◽  
pp. 148-148
Author(s):  
William E. Pierson ◽  
C. Warren Bierman
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Evaluation ◽  
Status Asthmaticus ◽  
Blood Gases ◽  
Intravenous Fluids ◽  
Arterial Blood Gases ◽  
Arterial Blood ◽  
Hospital Intensive Care Unit

The letters of Drs. Sloan and Goldstein deserve the following comments to clarify various points raised by their correspondence. In regard to Dr. Sloan's specific comments: (1) A child or adolescent who fails to respond to three injections of epinephrine (15 ml) is defined as being in status asthmaticus and is admitted to the hospital (intensive care unit). The outpatient use of intravenous fluids and medications is risky due to obvious lack of proper monitoring of intensive clinical evaluation and arterial blood gases.

scholarly journals Electrodermal Activity during Blood Pooling for Arterial Blood Gases Analysis in Sedated Adult Intensive Care Unit Patients

2018 ◽  
Vol 6 (1) ◽  
pp. 20 ◽  
Author(s):  
Theodoros Aslanidis ◽  
Vasilios Grosomanidis ◽  
Konstantinos Karakoulas ◽  
Athanasios Chatzisotiriou
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Electrodermal Activity ◽  
Blood Gases ◽  
Arterial Blood Gases ◽  
Adult Intensive Care Unit ◽  
Arterial Blood

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.

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