![]() ![]() High volume of heparin itself binds the electrolytes, thereby lowering the value of measured electrolytes on the ABG. ĭilution with heparin raises the volume of the sample, thereby lowering the value of the measured electrolytes on the ABG. Įxperts have cited theoretical reasons for these differences based on the chemical reactions employed in the AA and the auto-analyzers. Others have also found statistically significant differences in measures of pH, potassium, and hematocrit between ABG machines and leading bench-top analyzers. These differences significantly affected the calculated anion gap and strong ion difference values. Previous studies that measured the accuracy of electrolyte values obtained by ABG machines concluded that the results from two different measurement technologies differed significantly for plasma sodium and chloride concentrations. The United States Clinical Laboratory Improvement Amendment (US CLIA) 2006 accepts a difference of 0.5 mmol/l in measured potassium, and 4 mmol/l in measured sodium, from the gold standard measure of standard calibration solutions. The arterial blood gas (ABG) machines and AA differ in several aspects as listed in Table 1. Electrolytes are also measured during arterial blood gas analysis, but are traditionally rarely trusted for clinical decision-making because of the dearth of published research about the same. The operational cost of iSTAT and other similar equipment is a major deterrent to their utilization in developing systems of health care. Point-of-care testing for electrolytes is available from specialized equipment such as the iSTAT or Stat Profile Critical Care Xpress analyzers. Quick decisions that need to be made depending on electrolyte values hence are often made either blindly or are delayed. Typically, a turnaround time of about 15 min is noted on average in acute care laboratories of most tertiary care hospitals for the above. Routinely, all electrolytes are measured from serum by the auto-analyzers (AA) available in central laboratories of hospitals however, this is time-consuming. Įlectrolyte values are conventionally measured for all critical patients who present to the emergency department, for patients receiving fluid therapy, and for patients admitted to intensive care units (ICU). Point-of-care testing enables clinicians to initiate appropriate treatment for emergent conditions, thereby benefitting the patient both clinically and economically. We therefore conclude that critical decisions can be made by trusting the potassium values obtained from the arterial blood gas analysis. However, the difference between the measured sodium was found to be significant. Conclusionīased on the above analysis, the authors found no significant difference between the potassium values measured by the blood gas machine and the auto-analyzer. The mean ABG potassium value was 3.74 (SD 1.92), and the mean AA potassium value was 3.896 (SD 1.848) (p = 0.2679). ResultsĪ total of 200 paired samples were analyzed. Statistical analyses were performed using paired Student’s t test. Analyses were done on the ABL555 blood gas analyzer and the Dade Dimension RxL Max, both located in the central laboratory. MethodsĪfter approval by the ethics committee, an observational cohort study was conducted in which 200 paired venous and arterial samples from patients admitted to the Medical Intensive Care Unit (ICU) of Apollo Hospital, Hyderabad, India, were analyzed for electrolytes on the ABG machine and the AA. The authors hypothesized that there is no difference between the results obtained after measurement of electrolytes by the blood gas and auto-analyzers. Electrolyte values are measured both by arterial blood gas (ABG) analyzers and central laboratory auto-analyzers (AA), but a significant time gap exists between the availability of both these results, with the ABG giving faster results than the AA.
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