scholarly journals Concordance between point-of-care blood gas analysis and laboratory autoanalyzer in measurement of hemoglobin and electrolytes in critically ill patients

2018 ◽  
Vol 32 (6) ◽  
pp. e22425 ◽  
Author(s):  
Shivesh Prakash ◽  
Shailesh Bihari ◽  
Zhan Y. Lim ◽  
Santosh Verghese ◽  
Hemant Kulkarni ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Point Of Care ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas

CORRELATION OF VENOUS BLOOD GAS AND PULSE OXIMETRY WITH ARTERIAL BLOOD GAS IN CRITICALLY ILL PATIENTS

2021 ◽  
pp. 1-3
Author(s):  
Sritam Mohanty ◽  
Rangaraj Setlur ◽  
Jyoti Kumar Sinha
Keyword(s):  
Pulse Oximetry ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Venous Blood ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Gold Standard Method ◽  
Arterial Blood Gas ◽  
Arterial Blood

Introduction: Arterial blood gas (ABG) analysis is the gold standard method and frequently performed intervention to evaluate acid-base status along with adequacy of ventilation and oxygenation among patients with predominantly critical / acute diseases. Aims And Objectives: The aim of this study is to evaluate the correlation of VBG analysis and pulse oximetry (SpO2) with ABG analysis in critically ill patients. Materials And Methods:Intensive Care Unit (ICU), Command Hospital (Eastern Command), Kolkata, Adult patients requiring arterial blood gas analysis, JAN 2018 –JUNE 2019, 100 critically ill patients and Age – 18yrs and older, Sex – Either sex. Conclusion: In this study population of critically ill patients, pH and pCO2 on VBG analysis correlated with pH and pCO2 on ABG analysis. The SpO2 correlated well with pO2 on ABG analysis

scholarly journals Peripheral venous blood gas analysis: An alternative to arterial blood gas analysis for resuscitation and monitoring of critically ill patients.

2016 ◽  
Vol 4 (2) ◽  
pp. 92-95
Author(s):  
ASM Areef Ahsan ◽  
Mohammad Omar Faruq ◽  
Kaniz Fatema ◽  
Fatema Ahmed ◽  
Debasish Kumar Saha ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Base Excess ◽  
Blood Gases ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Acid Base ◽  
Venous Sample ◽  
Acid Base Status

Objective: This study was aimed to compare between arterial and peripheral venous samples for blood gases and acid base status in critically ill patients and to evaluate if venous sample is a better alternative for initial assessment and resuscitation.Methods: This prospective study was conducted on 50 patients of more than 18 years of age in the department of Critical Care Medicine, BIRDEM General Hospital. Arterial and peripheral venous samples were taken within five minutes of each other and analyzed immediately for blood gases and acid base status. Mean difference and Pearson's product moment correlation coefficient was used to compare the result.Results: Mean difference and correlation coefficient between arterial and peripheral venous sample for pH, bicarbonate, base excess, PaCO2 and TCO2 value showed high correlation (r > 0.9). Comparison of electrolyte and hematocrit between arterial and peripheral venous sample also showed high correlation (r > 0.9).Conclusion: Peripheral venous gas analysis for pH, bicarbonate, base excess, PCO2 and Electrolytes (Na+, K+) show good correlation with the respective arterial values. This result suggests that venous estimations can be an acceptable alternative to arterial measurements for managing critically ill patients.Bangladesh Crit Care J September 2016; 4 (2): 92-95

scholarly journals Short-Term Outcome and Characteristics of Critical Care for Non-Trauma Patients in the Emergency Department

2020 ◽  
Author(s):  
Jessika Stefanie Kreß ◽  
Marc Rüppel ◽  
Hendrik Haake ◽  
Jürgen vom Dahl ◽  
Sebastian Bergrath
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Blood Gas Analysis ◽  
Patient Characteristics ◽  
Gas Analysis ◽  
Trauma Patients ◽  
Blood Gas ◽  
Short Term ◽  
Resuscitation Room

Abstract Background: Emergency medical care for critically ill patients varies between different emergency departments (ED) and health care systems, while resuscitation of trauma patients is always performed within the ED. In many ED critically ill patients are treated and stabilized while in many German ED they are transferred to intensive care units (ICU) without performing of critical care measures in the ED. Against this background we conducted this retrospective analysis of prospectively collected critically ill patients treated with an ED critical care concept in a 754-bed teaching hospital. Methods: The collective of prospectively collected critically ill patients (October 1st 2018 to March 31st 2019) was analysed after ethical approval. Patient characteristics, performed critical care measures, short-term outcomes and the comparison of admission characteristics between survivors and non-survivors were evaluated. Additionally the accordance of ED diagnoses and discharge diagnoses were analysed.Results: Overall 243/19,854 patients (1.22%) were treated within the resuscitation room. After exclusion of trauma patients, 193 critically ill patients were included. Overall mortality was 29% (n=56), 24-hour mortality was 13% (n=25). Patient characteristics (vital signs, blood gas analysis) differed significantly between survivors and non-survivors except for respiratory rate and pain scale. Conducted critical care measures (number ± standard deviation; e.g. endotracheal intubation, arterial-line): 4.06±1.73 (survivors) and 4.70±2.0 (non-survivors) p=0.0453. The length of ED stay was 148.2±202.7 min. Admission diagnoses matched with hospital discharge diagnoses in 73.7%.Conclusions: Critical care stabilisation of non-trauma patients was feasible in routine care. The observed mortality was high and non-survivors showed significantly more impaired vital parameters and blood gas analysis parameters. Vital parameters together with blood gas analysis enable ED risk stratification of CIP. Although a first diagnostic workup was performed within the ED, admission and discharge diagnoses matched only in 73.7%. However, stabilisation and diagnostic workup of CIP enables optimal allocation to specialized ICUs. Future (randomised) trials have to evaluate of resuscitation room stabilisation for non-trauma patients is beneficial in contrast to direct ICU admission. Trial registration: The study was registered retrospectively in the Clinical Trials Centre of the RWTH Aachen University (Germany), registration number CTC-A 20-131.

Lactate, pH, and blood gas analysis in critically ill patients

1995 ◽  
Vol 39 ◽  
pp. 267-271 ◽  
Author(s):  
T. WALDAU ◽  
V. H. LARSEN ◽  
J. BONDE ◽  
N. FOGH-ANDERSEN
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas

Accuracy and Stability of a Subcutaneous Flash Glucose Monitoring System in Critically Ill Patients

2021 ◽  
pp. 193229682110172
Author(s):  
Hiromu Naraba ◽  
Tadahiro Goto ◽  
Mitsuhiro Tokuda ◽  
Tomohiro Sonoo ◽  
Hidehiko Nakano ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Glucose Monitoring ◽  
Blood Gas Analysis ◽  
Relative Difference ◽  
Gas Analysis ◽  
Blood Gas ◽  
Flash Glucose Monitoring ◽  
Grid Analysis ◽  
Error Grid

Background: Flash glucose monitoring (FGM) systems can reduce glycemic variability and facilitate blood glucose management within the target range. However, in critically ill patients, only small ( n < 30) studies have examined the accuracy of FGM and none have assessed the stability of FGM accuracy. We evaluated the accuracy and stability of FGM in critically ill patients. Method: This was a single-center, retrospective observational study. We included a total of 116 critically ill patients who underwent FGM for glycemic control. The accuracy of FGM was assessed as follows using blood gas glucose values as a reference: (1) numerical accuracy using the mean absolute relative difference, (2) clinical accuracy using consensus error grid analysis, and (3) stability of accuracy assessing 14-day trends in consensus error grid distribution. Results: FGM sensors remained in situ for a median of 6 [4, 11] days. We compared 2014 pairs of measurements between the sensor and blood gas analysis. Glucose values from the sensor were consistently lower, with a mean absolute relative difference of 13.8% (±16.0%), than those from blood gas analysis. Consensus error grid analysis demonstrated 99.4% of the readings to be in a clinically acceptable accuracy zone. The accuracy of FGM was stable across the 14 days after device insertion. Conclusions: FGM had acceptable reliability and accuracy to arterial blood gas analysis in critically ill patients. In addition, the accuracy of FGM persisted for at least 14 days. Our study promotes the potential usefulness of FGM for glycemic monitoring in critically ill patients.

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.

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.

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