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Soren Mikkelsen - One of the best experts on this subject based on the ideXlab platform.
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diagnostic value of prehospital arterial Blood Gas measurements a randomised controlled trial
Scandinavian Journal of Trauma Resuscitation and Emergency Medicine, 2019Co-Authors: Stine Thorhauge Zwisler, Yecatarina Zincuk, Caroline Bach Bering, Aleksander Zincuk, Mads Nybo, Soren MikkelsenAbstract:Arterial Blood Gas analysis is an important diagnostic tool in managing critically ill patients within the hospital. Whether prehospital application of this diagnostic modality contributes to more exact diagnoses and treatments in critically ill prehospital patients is unknown. The aim of this study was to establish whether access to arterial Blood Gas analysis increased the prehospital diagnostic accuracy of prehospital anaesthesiologists. Furthermore, we investigated whether prehospital Blood Gas analysis resulted in therapeutic interventions that would not have been carried out if the arterial Blood Gas analyser had not been available. In a prospective randomised study, two groups of prehospital adult patients with acute critical illness were compared. All patients received standard prehospital care. In the intervention group, an arterial Blood Gas sample was analysed prehospitally. The primary outcome was the impact of Blood Gas analysis on the accuracy of prehospital diagnoses. Furthermore, we registered any therapeutic interventions that were carried out as a direct result of the Blood Gas analysis. A total of 310 patients were included in the study. Eighty-eight of these patients were subsequently excluded, primarily due to difficulties in obtaining post hoc consent or venous sampling or other technical difficulties. A total of 102 patients was analysed in the arterial Blood Gas group (ABG group), while 120 patients were analysed in the standard care group (noABG group). In 78 of the 102 patients in the ABG group, the prehospital physician reported that ABG analysis increased their perceived diagnostic precision. In 81 cases in the noABG group, the lack of arterial Blood Gas analysis was perceived to have decreased diagnostic accuracy. The claim that ABG analysis increased diagnostic accuracy could, however, not be substantiated as there was no difference in the number of un-specific diagnoses between the groups. Blood Gas analysis increased the probability of targeting specific prehospital therapeutic interventions and led to 159 interventions, including intubation, ventilation and/or upgrading the level of urgency, in 71 ABG-group patients (p < 0.001). Although prehospital arterial Blood Gas analysis did not improve the accuracy of the prehospital diagnoses assigned to patients, it significantly increased the quality of treatment provided to patients with acute critical illness. ClinicalTrials.gov, NCT03006692 , retrospectively registered six months after first patient entry.
Ismail Kurt - One of the best experts on this subject based on the ideXlab platform.
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Comparison of Blood Gas, electrolyte and metabolite results measured with two different Blood Gas analyzers and a core laboratory analyzer
Scandinavian Journal of Clinical and Laboratory Investigation, 2014Co-Authors: Metin Uyanik, Erdim Sertoglu, Huseyin Kayadibi, Serkan Tapan, Muhittin Serdar, Cumhur Bilgi, Ismail KurtAbstract:AbstractBackground. Blood Gas analyzers (BGas) are important in assessing and monitoring critically ill patients. However, the random use of BGas to measure Blood Gases, electrolytes and metabolites increases the variability in test results. Therefore, this study aimed to investigate the correlation of Blood Gas, electrolyte and metabolite results measured with two BGas and a core laboratory analyzer. Methods. A total of 40 arterial Blood Gas samples were analyzed with two BGas [(Nova Stat Profile Critical Care Xpress (Nova Biomedical, Waltham, MA, USA) and Siemens Rapidlab 1265 (Siemens Healthcare Diagnostics Inc., Tarrytown, NY, USA)) and a core laboratory analyzer [Olympus AU 2700 autoanalyzer (Beckman-Coulter, Inc., Fullerton, CA, USA)]. The results of pH, pCO2, pO2, SO2, sodium (Na+), potassium (K+), calcium (Ca+ 2), chloride (Cl−), glucose, and lactate were compared by Passing-Bablok regression analysis and Bland-Altman plots. Results. The present study showed that there was negligible variability o...
Kaisa Kurvinen - One of the best experts on this subject based on the ideXlab platform.
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interchangeability of Blood Gas electrolyte and metabolite results measured with point of care Blood Gas and core laboratory analyzers
Clinical Chemistry and Laboratory Medicine, 2011Co-Authors: Aila Leino, Kaisa KurvinenAbstract: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, pCO(2), pO(2) and Ca(2+), 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(+), Ca(2+), 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.
Shigeho Morita - One of the best experts on this subject based on the ideXlab platform.
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the Blood Gas partition coefficient of xenon may be lower than generally accepted
BJA: British Journal of Anaesthesia, 1998Co-Authors: Takahisa Goto, Kunio Suwa, Shoichi Uezono, Fumito Ichinose, M Uchiyama, Shigeho MoritaAbstract:The Blood-Gas partition coefficients of xenon, reported more than 25 yr ago in the literature, vary considerably from 0.13 to 0.20. Consequently, we have determined this variable by directly injecting xenon-saturated Blood into a Gas chromatograph-mass spectrometer. This technique yielded a Blood-Gas partition coefficient for xenon of 0.115 (95% confidence interval 0.107-0.123). The solubility in water measured identically was 0.096, consistent with the reported value of 0.085. These data and a detailed review of the literature strongly suggest that the Blood-Gas partition coefficient of xenon may be lower than the generally accepted value of 0.14.
Metin Uyanik - One of the best experts on this subject based on the ideXlab platform.
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Comparison of Blood Gas, electrolyte and metabolite results measured with two different Blood Gas analyzers and a core laboratory analyzer
Scandinavian Journal of Clinical and Laboratory Investigation, 2014Co-Authors: Metin Uyanik, Erdim Sertoglu, Huseyin Kayadibi, Serkan Tapan, Muhittin Serdar, Cumhur Bilgi, Ismail KurtAbstract:AbstractBackground. Blood Gas analyzers (BGas) are important in assessing and monitoring critically ill patients. However, the random use of BGas to measure Blood Gases, electrolytes and metabolites increases the variability in test results. Therefore, this study aimed to investigate the correlation of Blood Gas, electrolyte and metabolite results measured with two BGas and a core laboratory analyzer. Methods. A total of 40 arterial Blood Gas samples were analyzed with two BGas [(Nova Stat Profile Critical Care Xpress (Nova Biomedical, Waltham, MA, USA) and Siemens Rapidlab 1265 (Siemens Healthcare Diagnostics Inc., Tarrytown, NY, USA)) and a core laboratory analyzer [Olympus AU 2700 autoanalyzer (Beckman-Coulter, Inc., Fullerton, CA, USA)]. The results of pH, pCO2, pO2, SO2, sodium (Na+), potassium (K+), calcium (Ca+ 2), chloride (Cl−), glucose, and lactate were compared by Passing-Bablok regression analysis and Bland-Altman plots. Results. The present study showed that there was negligible variability o...