The Experts below are selected from a list of 1260 Experts worldwide ranked by ideXlab platform
Bernard J Roth - One of the best experts on this subject based on the ideXlab platform.
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is ph Paper an acceptable low cost alternative to the blood gas analyzer for determining pleural fluid ph
Chest, 1997Co-Authors: Emil P Lesho, Bernard J RothAbstract:Background Our laboratory uses pH Paper rather than a blood gas analyzer to measure pleural fluid pH to decrease cost and avoid analyzer malfunction due to viscous fluids. Methods To compare these two methods of determining pleural fluid pH, 42 patients undergoing diagnostic or therapeutic thoracentesis had two 1-mL aliquots of pleural fluid anaerobically collected in a heparinized syringe and placed on ice. pH measurements were made using Litmus Paper (pHydron Vivid 6–8 brand Litmus Paper; MicroEssential Labs; Brooklyn, NY) and the model 995-Hb blood gas analyzer (AVL Instruments; Roswell, GA) within 1 h of collection. Agreement analysis was performed in three ways: on the entire group; in subcategories of complicated or uncomplicated parapneumonic effusions ( 7.3); and in subcategories of poor prognosis or better prognosis malignant effusions( 7.3). Results pH measured with pH Paper was significantly more variable (SD=0.55, coefficient of variation [CV] = 7.5%;) than was pH measured with the blood gas analyzer (SD=0.11, CV=1.5%;). There was no significant correlation between values obtained with the two techniques (r=— 0.26, SD of the differences=0.59). Using the pH subcategories, there was 72%; discordance in classification between Litmus Paper and arterial blood gas (ABG) determinations for patients with parapneumonic effusions. In patients with malignant effusions, there was 30%; discordance. The pH values obtained by the ABG analyzer predicted tube thoracostomy 72%; of the time, whereas the pH values obtained using pH Paper were consistent only 36%; of the time. Conclusion Determination of pleural fluid pH using pH Paper is unreliable and should not be considered an acceptable alternative to the blood gas analyzer. There is no need to determine pH on purulent samples. Hospital laboratories will be more likely to allow the use of the ABG analyzer on fluids other than blood if clinicians keep this in mind.
William D Hardie - One of the best experts on this subject based on the ideXlab platform.
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measuring pleural fluid ph high correlation of a handheld unit to a traditional tabletop blood gas analyzer
Chest, 2000Co-Authors: Gary L Kohn, William D HardieAbstract:Study purposes: To survey hospital laboratories in the, United States to determine methods used for measuring pleural fluid p, H,and to compare pleural fluid p, H values obtained with a traditionaltabletop blood gas analyzer (BGA) to those obtained with a handheldanalyzer. Methods: Hospital laboratories nationwidewere contacted by telephone to survey the methods used to measurepleural fluid p, H. In a second phase, pleural fluid was prospectivelycollected from 19 pediatric and adult patients with pleural effusions, and pleural fluid p, H was measured simultaneously with a traditionaltabletop BGA and with a handheld unit. Results: Atotal of 220 hospital laboratories were contacted by telephone, and 166responded (75%). The methods for determining pleural fluid p, H for allhospital laboratories were p, H meter (35%; n = 59), BGA (32%;n = 53), and Litmus Paper (31%: n = 51); 2% (n = 3) did notperform the test. University hospitals were more likely to use a BGA,compared to community hospitals (p r = 0.993; degrees offreedom = 36). Conclusion: Most hospitallaboratories in the United States do not measure pleural fluid p, H usinga traditional BGA and use alternative methods that have previously beenshown to be inaccurate. Pleural fluid p, H obtained by a handheld unithas a high degree of correlation to that of a traditional tabletop BGA,and it offers a satisfactory alternative for laboratories reluctant tomeasure pleural fluid p, H with a BGA.
Emil P Lesho - One of the best experts on this subject based on the ideXlab platform.
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is ph Paper an acceptable low cost alternative to the blood gas analyzer for determining pleural fluid ph
Chest, 1997Co-Authors: Emil P Lesho, Bernard J RothAbstract:Background Our laboratory uses pH Paper rather than a blood gas analyzer to measure pleural fluid pH to decrease cost and avoid analyzer malfunction due to viscous fluids. Methods To compare these two methods of determining pleural fluid pH, 42 patients undergoing diagnostic or therapeutic thoracentesis had two 1-mL aliquots of pleural fluid anaerobically collected in a heparinized syringe and placed on ice. pH measurements were made using Litmus Paper (pHydron Vivid 6–8 brand Litmus Paper; MicroEssential Labs; Brooklyn, NY) and the model 995-Hb blood gas analyzer (AVL Instruments; Roswell, GA) within 1 h of collection. Agreement analysis was performed in three ways: on the entire group; in subcategories of complicated or uncomplicated parapneumonic effusions ( 7.3); and in subcategories of poor prognosis or better prognosis malignant effusions( 7.3). Results pH measured with pH Paper was significantly more variable (SD=0.55, coefficient of variation [CV] = 7.5%;) than was pH measured with the blood gas analyzer (SD=0.11, CV=1.5%;). There was no significant correlation between values obtained with the two techniques (r=— 0.26, SD of the differences=0.59). Using the pH subcategories, there was 72%; discordance in classification between Litmus Paper and arterial blood gas (ABG) determinations for patients with parapneumonic effusions. In patients with malignant effusions, there was 30%; discordance. The pH values obtained by the ABG analyzer predicted tube thoracostomy 72%; of the time, whereas the pH values obtained using pH Paper were consistent only 36%; of the time. Conclusion Determination of pleural fluid pH using pH Paper is unreliable and should not be considered an acceptable alternative to the blood gas analyzer. There is no need to determine pH on purulent samples. Hospital laboratories will be more likely to allow the use of the ABG analyzer on fluids other than blood if clinicians keep this in mind.
A. R. Opekun - One of the best experts on this subject based on the ideXlab platform.
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Equivalence of Litmus Paper and intragastric pH probes for intragastric pH monitoring in the intensive care unit
Critical care medicine, 1994Co-Authors: Robert Levine, Robert E. Fromm, Mojtaba Mojtahedzadeh, A. A. Baghaie, A. R. OpekunAbstract:OBJECTIVE To compare the accuracy of Litmus Paper-determined gastric pH to a nasogastric graphite antimony pH probe. DESIGN A prospective clinical trial of gastric pH determination in patients enrolled in a study of histamine-2-receptor (H2) antagonists. SETTING The medical intensive care unit (ICU) of a 450-bed county hospital. PATIENTS Critically ill ICU patients requiring stress ulcer prophylaxis. INTERVENTIONS Using a crossover design, the patients were randomized to initially receive an H2 antagonist by continuous infusion or intravenous bolus, and subsequently were crossed over to the other limb of the study. MEASUREMENTS AND MAIN RESULTS Gastric pH was determined using pH-sensitive Litmus Paper at the initiation of each limb of the study and at 1, 2, 4, and 8 hrs after the initiation of H2 receptor antagonist therapy. In addition, gastric pH was continuously determined over the same time period utilizing a graphite antimony pH probe. Gastric pH measurements determined with Litmus Paper and intragastric pH probes demonstrated an excellent correlation (r2 = .93, p .47), and the kappa statistic (0.95, p < .001) demonstrated excellent concordance. Bias measurement was 0.01 (95% confidence interval = -0.155 to 0.176). CONCLUSIONS Measurement of intragastric pH, using pH-sensitive Litmus Paper, is both sensitive and specific when utilizing a graphite antimony nasogastric pH probe as a reference standard. Litmus Paper-determined gastric pH testing is both easy to perform and inexpensive. Therefore, based on the current data, we believe this technique (i.e., Litmus Paper determined gastric pH testing) to be the method of choice for determination of intragastric pH in patients at risk for stress gastric ulcers in the medical ICU.
Gary L Kohn - One of the best experts on this subject based on the ideXlab platform.
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measuring pleural fluid ph high correlation of a handheld unit to a traditional tabletop blood gas analyzer
Chest, 2000Co-Authors: Gary L Kohn, William D HardieAbstract:Study purposes: To survey hospital laboratories in the, United States to determine methods used for measuring pleural fluid p, H,and to compare pleural fluid p, H values obtained with a traditionaltabletop blood gas analyzer (BGA) to those obtained with a handheldanalyzer. Methods: Hospital laboratories nationwidewere contacted by telephone to survey the methods used to measurepleural fluid p, H. In a second phase, pleural fluid was prospectivelycollected from 19 pediatric and adult patients with pleural effusions, and pleural fluid p, H was measured simultaneously with a traditionaltabletop BGA and with a handheld unit. Results: Atotal of 220 hospital laboratories were contacted by telephone, and 166responded (75%). The methods for determining pleural fluid p, H for allhospital laboratories were p, H meter (35%; n = 59), BGA (32%;n = 53), and Litmus Paper (31%: n = 51); 2% (n = 3) did notperform the test. University hospitals were more likely to use a BGA,compared to community hospitals (p r = 0.993; degrees offreedom = 36). Conclusion: Most hospitallaboratories in the United States do not measure pleural fluid p, H usinga traditional BGA and use alternative methods that have previously beenshown to be inaccurate. Pleural fluid p, H obtained by a handheld unithas a high degree of correlation to that of a traditional tabletop BGA,and it offers a satisfactory alternative for laboratories reluctant tomeasure pleural fluid p, H with a BGA.