Evaluation of point-of-care analyzers' ability to reduce bias in conductivity-based hematocrit measurement during cardiopulmonary bypass.
Most point-of-care testing analyzers use the conductivity method to measure hematocrit (hct). During open-heart surgery, blood-conductivity is influenced by shifts in electrolyte and colloid concentrations caused by infusion media used, and this may lead to considerable bias in the hct measurement....
| Publicado en: | Journal of Clinical Monitoring & Computing Vol. 28; no. 2; pp. 133 - 139 |
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| Autores principales: | , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
Apr2014
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104042566&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104042566 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13871307 OHC jtl: Journal of Clinical Monitoring & Computing issn: 13871307 maglogo: N pubinfo: dt: Apr2014 vid: 28 iid: 2 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 104042566 NLM23990287 2012504216 10.1007/s10877-013-9504-z NLM23990287 104042566 ppf: 133 ppct: 6 formats: fmt: @attributes: type: P tig: atl: Evaluation of point-of-care analyzers' ability to reduce bias in conductivity-based hematocrit measurement during cardiopulmonary bypass. aug: au: Teerenstra, Steven Steinfelder-Visscher, Jacoline Gunnewiek, Jacqueline Klein Weerwind, Patrick W affil: Department for Health Evidence, Section of Biostatistics (133), Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands, z824116@umcn.nl. sug: subj: Artifacts Cardiopulmonary Bypass Equipment and Supplies Clinical Information Systems Electrochemistry Equipment and Supplies Hematocrit Equipment and Supplies Intraoperative Monitoring Equipment and Supplies Equipment Design Equipment Failure Human Reproducibility of Results Sensitivity and Specificity ab: Most point-of-care testing analyzers use the conductivity method to measure hematocrit (hct). During open-heart surgery, blood-conductivity is influenced by shifts in electrolyte and colloid concentrations caused by infusion media used, and this may lead to considerable bias in the hct measurement. We evaluated to what extent different analyzers correcting for 0, 1, 2, or 3 factors, respectively, compensated for this electrolyte/colloid interference: (1) the conductivity method with no correction (IRMA), (2) with a [Na(+)]-correction (GEM Premier 3000), (3) with a [Na(+)]/[K(+)]-correction (i-STAT), and (4) with a [Na(+)]/[K(+)]-correction in combination with an algorithm that estimates the protein dilution [i-STAT in cardiopulmonary bypass (CPB)-mode]. Bias in hct was measured during three consecutive stages of a CPB procedure: (I) before CPB, (II) start of CPB and (III) after cardioplegia. In order of high to low electrolyte/colloid interference: the analyzer with no correction, [Na(+)]-correction, [Na(+)/]/[K(+)]-correction, and [Na(+)/]/[K(+)]/estimated protein-correction showed a change of bias from stage I to stage III of -3.9 ± 0.5, -3.4 ± 0.4, -2.1 ± 0.5, -0.3 ± 0.5%. We conclude that correcting for more parameters (Na(+), K(+), estimated protein) gives less bias, but residual bias remains even after [Na(+)/]/[K(+)]/estimated protein-correction. This suggests that a satisfactory algorithm should also correct for other colloidal factors than protein. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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