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Agreement between paired blood gas values in samples transported either by a pneumatic system or by human courier

  • John Victor Peter , Shalom Patole , Jude Joseph Fleming , Ratnasamy Selvakumar and Petra L. Graham
Published/Copyright: May 28, 2011
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 49 Issue 8

Abstract

Background: Rapid accurate assessment of metabolic derangements is crucial in the critically ill. We evaluated if arterial blood gas (ABG) samples transported through a pneumatic tube system (PTS) agreed with values transported by a human courier.

Methods: In this prospective study of 50-paired ABG samples, the couriered reference ABG was compared with those transported by PTS. Agreement was summarised by the mean difference with 95% limits of agreement (LOA) and Lin's concordance correlation (pc).

Results: The mean (±SD) time from sampling to analysis was 35.7±23.2 (courier) and 38.6±22.1 (PTS) minutes. Agreement was good between courier and PTS for pH, PaCO2, bicarbonate, oxygen saturation and PaO2 values (pc>0.97). Although the mean difference in PaO2 values between PTS and courier was small (–0.9 mm Hg) and the agreement was good, individual differences were clinically significant (95% LOA –40.8 to 39.0). For PaO2 <160 mm Hg, analysis of PTS samples yielded erroneously high PaO2 values and vice versa for PaO2>160 mm Hg compared to manual courier. This suggested exaggerated oxygen movement between the blood sample and air in the PTS.

Conclusions: In this study, analysis of samples transported through the PTS resulted in clinically unacceptable PaO2 values. Delay in transport and analysis of ABG samples should be avoided and samples transported manually if they cannot be assessed on-site.

Keywords: agreement; arterial blood gas; Bland-Altman; concordance; pneumatic tube system; point of care testing
Corresponding author: Dr. Petra L. Graham, BSc, MS, PhD, Lecturer, Faculty of Science, Department of Statistics, Macquarie University, NSW 2109, Australia Phone: +61 2 9850 6138, Fax: +61 2 9850 7669
Received: 2011-01-31
Accepted: 2011-03-01
Published Online: 2011-05-28
Published in Print: 2011-08-01

©2011 by Walter de Gruyter Berlin Boston

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https://doi.org/10.1515/CCLM.2011.611
Keywords for this article
agreement; arterial blood gas; Bland-Altman; concordance; pneumatic tube system; point of care testing

Articles in the same Issue

  1. Editorial
  2. Pneumatic tube delivery systems for patient samples: evidence of quality and quality of evidence
  3. Reviews
  4. Translating pharmacogenetics into clinical practice: interleukin (IL)28B and inosine triphosphatase (ITPA) polymophisms in hepatitis C virus (HCV) infection
  5. New biomarkers for acute renal injury
  6. Minireview
  7. Post-mortem biochemistry of vitreous humor and glucose metabolism: an update
  8. Opinion Paper
  9. International Osteoporosis Foundation and International Federation of Clinical Chemistry and Laboratory Medicine Position on bone marker standards in osteoporosis
  10. Guidelines and Recommendations
  11. IFCC international conventional reference procedure for the measurement of free thyroxine in serum
  12. Genetics and Molecular Diagnostics
  13. Improving clinical laboratory efficiency: a time-motion evaluation of the Abbott m2000 RealTime and Roche COBAS AmpliPrep/COBAS TaqMan PCR systems for the simultaneous quantitation of HIV-1 RNA and HCV RNA
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  15. Customer satisfaction survey to improve the European cystic fibrosis external quality assessment scheme
  16. General Clinical Chemistry and Laboratory Medicine
  17. Effect of sample collection, temperature and time of storage on β-galactosidase and total hexosaminidase activities in dried blood collected on filter paper
  18. Agreement between paired blood gas values in samples transported either by a pneumatic system or by human courier
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  23. Cerebrospinal fluid findings in infants with pertussis or parapertussis1)
  24. Calcium pyrophosphate and monosodium urate crystals in synovial fluid as a cause of pseudoeosinophilia
  25. Cardiovascular Disease
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  29. Diagnosis and genotyping of Plasmodium falciparum by a DNA biosensor based on quartz crystal microbalance (QCM)
  30. Evaluation of two automated chemiluminescence immunoassays, the LIAISON Treponema Screen and the ARCHITECT Syphilis TP, and the Treponema pallidum particle agglutination test for laboratory diagnosis of syphilis
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  35. Towards laboratory knowledge, not data, in 70% of clinical decision-making. What “knowledge management” can add to clinical practice?
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