scholarly journals Comparison of Arterial Blood Gas Analysis versus Central Laboratory Electrolyte and Hemoglobin Determination in Birat Medical College and Teaching Hospital

2020 ◽  
Vol 5 (1) ◽  
pp. 960-963
Author(s):  
Batsalya Arjyal ◽  
Lalit Kumar Rajbanshi ◽  
Kanak Khanal ◽  
Akriti Bajracharya
Keyword(s):  
Clinical Laboratory ◽  
Critically Ill Patient ◽  
Blood Gas ◽  
Central Laboratory ◽  
Gas Analyzer ◽  
Sodium Potassium ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Blood Gas Analyzer ◽  
Hemoglobin Measurement

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.

The evaluation of point-of-care testing for determining hemoglobin levels in geriatric intensive care patients

2018 ◽  
Vol 42 (5) ◽  
pp. 189-193
Author(s):  
Tevfik Honca ◽  
Mehtap Honca
Keyword(s):  
Geriatric Patients ◽  
Point Of Care ◽  
Capillary Blood ◽  
Blood Gas ◽  
Gas Analyzer ◽  
Point Of Care Testing ◽  
Arterial Blood ◽  
Hematology Analyzer ◽  
Automated Hematology Analyzer ◽  
Blood Gas Analyzer

AbstractBackgroundThe aim of the present study was to compare hemoglobin (Hb) levels determined by point-of-care testing (POCT) HemoCue® and arterial blood gas analyzer using an automated hematology analyzer in critically ill geriatric patients.MethodsForty geriatric patients requiring intensive care treatment were included in the study. Arterial blood sample was analyzed using HemoCue® (HemoCue®; Hb 201+, Angelholm, Sweden) (HbHemoCueArterial), blood gas analyzer (Techno Medica, Gastat1800 series, Japan) (HbBGA) and an automated hematology analyzer (Cell Dyne 3700 System, Abbott Laboratories, USA) (HbLab) as a reference method. Capillary blood measurements were performed (HbHemoCueCapillary) using HemoCue® at bedside. Bland-Altman analysis was applied to the results.ResultsWe found a positive correlation between the Hb measurements of HemoCueCapillary, HemoCueArterial and automated hematology analyzer (r-values were 0.799 and 0.922, respectively) and p<0.001. There was also a positive correlation between the Hb measurements of blood gas analyzer and automated hematology analyzer (r = 0.878) and p<0.001. The bias and limits of agreement were 0.32 and −2.5±3.14 g/dL for the HbHemoCueCapillary, 0.64 and −1.03±2.31 g/dL for the HbHemoCueArterial and −1.2 and −4.45±2.05 g/dL for the HbBGA. Inotropic agent administration did not affect the Hb values in all groups.ConclusionsBoth HemoCueCapillary and HemoCueArterial are sufficiently accurate and correlated with automated hematology analyzer in geriatric critically ill patients if used correctly. In terms of Hb levels, arterial and capillary blood sample measurements with HemoCue® provided more clinically acceptable accuracy than blood gas analysis system.

scholarly journals Establishing and Evaluating Autoverification Rules with Intelligent Guidelines for Arterial Blood Gas Analysis in a Clinical Laboratory

2018 ◽  
Vol 23 (6) ◽  
pp. 631-640
Author(s):  
Jie Wu ◽  
Meichen Pan ◽  
Huizhen Ouyang ◽  
Zhili Yang ◽  
Qiaoxin Zhang ◽  
...  
Keyword(s):  
Error Rate ◽  
Clinical Laboratory ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Clinical Samples ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Laboratory Test Results ◽  
Manual Verification

Arterial blood gas (ABG) analysis is important for acutely ill patients and should be performed by qualified laboratorians. The existing manual verifications are tedious, time-consuming, and prone to send wrong reports. Autoverification uses computer-based rules to verify clinical laboratory test results without manual review. To date, no data are available on the use of autoverification for ABG analysis. All autoverification rules were established according to AUTO10-A. Additionally, the rules were established using retrospective patient data, and then validated by actual clinical samples in a “live” environment before go-live. The average autoverification passing rate was 75.5%. The turnaround time (TAT) was reduced by 33.3% (27 min vs 18 min). Moreover, the error rate fell to 0.05% after implementation. Statistical analysis resulted in a kappa statistic of 0.92 ( p < 0.01), indicating close agreement between autoverification and senior technician verification, and the chi-square value was 22.4 ( p < 0.01), indicating that the autoverification error rate was lower than the manual verification error rate. Results showed that implementing autoverification rules with intelligent guidelines for ABG analysis of patients with critical illnesses could decrease the number of samples requiring manual verification, reduce TAT, and eliminate errors, allowing laboratorians to concentrate more time on abnormal samples, patient care, and collaboration with physicians.

scholarly journals Potential Inaccuracies in Chloride Measurements in Patients with Severe Metabolic Acidosis

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Tetsuya Makiishi ◽  
Naomasa Nishimura ◽  
Keiko Yoshioka ◽  
Shinya Yamamoto ◽  
Ryuichi Mitsuhashi ◽  
...  
Keyword(s):  
Point Of Care ◽  
Blood Gas ◽  
Central Laboratory ◽  
Gas Analyzer ◽  
Severe Metabolic Acidosis ◽  
Acid Base ◽  
Factors Associated ◽  
Acid Base Status ◽  
Blood Gas Analyzer ◽  
Laboratory Analyzer

Background. To address the cause(s) of the significant differences in chloride (Cl-) concentrations between point-of-care blood gas analyzers and central laboratory analyzers.Methods. Cl-concentrations measured simultaneously by a blood gas analyzer (ABL800 FLEX) and a central laboratory analyzer (Hitachi7600) were collected in patients with severe acidemia (pH<7.20) (n=32) and were examined for correlations between differences in Cl-and factors associated with the acid-base status. Cl-concentrations were measured with both analyzers for samples with different concentrations of lactate, inorganic phosphate, or bicarbonate (HCO3   −).Results. The differences in Cl-concentrations were correlated withHCO3   −concentrations (r=0.72,P<0.0001) and anion gap (r=0.69,P<0.0001). Only the addition ofHCO3   −proportionately increased Cl-levels measured by a Hitachi7600, but it did not affect those measured by an ABL800FLEX.Conclusion. Cl-measurements with some analyzers may be influenced byHCO3   −concentrations, which could result in the observed discrepancies.

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