Interchangeability of blood gas, electrolyte and metabolite results measured with point-of-care, blood gas and core laboratory analyzers
-
Aila Leino
und
Kaisa Kurvinen
Abstract
Background: The random use of point-of-care, blood gas and core laboratory analyzers to measure electrolytes and metabolites increases the variability in test results. This study was designed to determine whether these results performed on whole blood (point-of-care and blood gas) and plasma (core laboratory) platforms are interchangeable without a risk of clinically relevant discrepancies.
Methods: The interchangeability of the blood gas analysis, electrolytes, glucose, lactate and hemoglobin results performed with three stat platforms (i-STAT, Radiometer ABL 825, RapidLab 865) and two core laboratory platforms (Roche Modular P800 and Sysmex XE-2100) were evaluated using samples from critically ill patients.
Results: For pH, pCO2, pO2 and Ca2+, good correlation (r-values 0.96–1.00) was observed for all comparative analyzers and the biases were within clinically acceptable limits. Potassium, sodium, glucose, lactate and hemoglobin measured with stat analyzers was highly correlated with measurements performed using the laboratory analyzers, r-values 0.89–1.00 and slopes 0.83–1.07. Mean differences with significant bias (p<0.0001) were found for sodium with blood gas analyzers and hemoglobin with i-STAT.
Conclusions: The blood gas, K+, Na+, Ca2+, glucose and lactate results measured with stat and core laboratory analyzers can be used in different clinical settings for critical care management. However, when monitoring small changes in sodium concentrations, the use of single analyzer is encouraged to avoid analytical differences (acceptance limit ±2%) and misinterpretation of results measured with multiple analyzers. The users of the i-STAT at low hemoglobin values overdiagnose anaemia. Thus, prior to transfusion, the use of hemoglobin concentrations measured with laboratory analyzers is preferable.
©2011 by Walter de Gruyter Berlin Boston
Artikel in diesem Heft
- Editorial
- Method comparison: where do we draw the line?
- Review
- Current role of liquid chromatography coupled to mass spectrometry in clinical toxicology screening methods
- Minireview
- Molecular diagnostics for pharmacogenomic testing of fluoropyrimidine based-therapy: costs, methods and applications
- Opinion Paper
- Preanalytical quality improvement: from dream to reality
- Point
- Towards more complete specifications for acceptable analytical performance – a plea for error grid analysis
- Counterpoint
- Closing the brain-to-brain loop in laboratory testing
- General Clinical Chemistry and Laboratory Medicine
- Harmonization of growth hormone measurements with different immunoassays by data adjustment
- Comparison of the results from two different External Quality Assessment Schemes supports the utility of robust quality specifications
- High-throughput LC-MS/MS method for monitoring sirolimus and everolimus in the routine clinical laboratory
- Performance of the Roche Total Mycophenolic Acid® assay on the Cobas Integra 400®, Cobas 6000® and comparison to LC-MS/MS in liver transplant patients
- Diagnostic efficiency of truncated area under the curve from 0 to 2 h (AUC0–2) of mycophenolic acid in kidney transplant recipients receiving mycophenolate mofetil and concomitant tacrolimus
- Good performance of an immunoassay based method for nevirapine measurements in human breast milk
- Measurement of plasma amino acids by Ultraperformance® Liquid Chromatography
- Interchangeability of blood gas, electrolyte and metabolite results measured with point-of-care, blood gas and core laboratory analyzers
- Granularity Index of the SYSMEX XE-5000 hematology analyzer as a replacement for manual microscopy of toxic granulation neutrophils in patients with inflammatory diseases
- Direct chromogenic substrate immuno-capture activity assay for testing of factor VII-activating protease
- The antinuclear antibody assay: developing criteria for reflexive anti-dsDNA antibody testing in a laboratory setting
- A simple liquid chromatography-tandem mass spectrometry method for measuring metanephrine and normetanephrine in urine
- Monoclonal gammopathy missed by capillary zone electrophoresis
- Adaptation of the Diazyme Direct Enzymatic HbA1c Assay for a microplate reader at room temperature
- Validation and Outcome Studies
- Laboratory assessment of iron status in pregnancy
- Cardiovascular Diseases
- Blood cells characteristics as determinants of acute myocardial infarction
- No evidence for an association between the rs2824292 variant at chromosome 21q21 and ventricular fibrillation during acute myocardial infarction in a German population
- Letters to the Editor
- Letter to the Editor Reply: Statistical methods for assessment of added usefulness of new biomarkers
- Reply to Vavrova et al. Clin Chem Lab Med 2011;49:89–92
Artikel in diesem Heft
- Editorial
- Method comparison: where do we draw the line?
- Review
- Current role of liquid chromatography coupled to mass spectrometry in clinical toxicology screening methods
- Minireview
- Molecular diagnostics for pharmacogenomic testing of fluoropyrimidine based-therapy: costs, methods and applications
- Opinion Paper
- Preanalytical quality improvement: from dream to reality
- Point
- Towards more complete specifications for acceptable analytical performance – a plea for error grid analysis
- Counterpoint
- Closing the brain-to-brain loop in laboratory testing
- General Clinical Chemistry and Laboratory Medicine
- Harmonization of growth hormone measurements with different immunoassays by data adjustment
- Comparison of the results from two different External Quality Assessment Schemes supports the utility of robust quality specifications
- High-throughput LC-MS/MS method for monitoring sirolimus and everolimus in the routine clinical laboratory
- Performance of the Roche Total Mycophenolic Acid® assay on the Cobas Integra 400®, Cobas 6000® and comparison to LC-MS/MS in liver transplant patients
- Diagnostic efficiency of truncated area under the curve from 0 to 2 h (AUC0–2) of mycophenolic acid in kidney transplant recipients receiving mycophenolate mofetil and concomitant tacrolimus
- Good performance of an immunoassay based method for nevirapine measurements in human breast milk
- Measurement of plasma amino acids by Ultraperformance® Liquid Chromatography
- Interchangeability of blood gas, electrolyte and metabolite results measured with point-of-care, blood gas and core laboratory analyzers
- Granularity Index of the SYSMEX XE-5000 hematology analyzer as a replacement for manual microscopy of toxic granulation neutrophils in patients with inflammatory diseases
- Direct chromogenic substrate immuno-capture activity assay for testing of factor VII-activating protease
- The antinuclear antibody assay: developing criteria for reflexive anti-dsDNA antibody testing in a laboratory setting
- A simple liquid chromatography-tandem mass spectrometry method for measuring metanephrine and normetanephrine in urine
- Monoclonal gammopathy missed by capillary zone electrophoresis
- Adaptation of the Diazyme Direct Enzymatic HbA1c Assay for a microplate reader at room temperature
- Validation and Outcome Studies
- Laboratory assessment of iron status in pregnancy
- Cardiovascular Diseases
- Blood cells characteristics as determinants of acute myocardial infarction
- No evidence for an association between the rs2824292 variant at chromosome 21q21 and ventricular fibrillation during acute myocardial infarction in a German population
- Letters to the Editor
- Letter to the Editor Reply: Statistical methods for assessment of added usefulness of new biomarkers
- Reply to Vavrova et al. Clin Chem Lab Med 2011;49:89–92
