A head to head evaluation of 8 biochemical scanning tools for unmeasured ions.
We aimed to evaluate the sensitivity and specificity of 8 biochemical scanning tools in signalling the presence of unmeasured anions. We used blood gas and biochemical data from 15 patients during and after cardio-pulmonary bypass. Sampling time-points were pre-bypass (T1), 2 min post equilibration...
| Published in: | Journal of Clinical Monitoring & Computing Vol. 31; no. 2; pp. 449 - 458 |
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| Main Authors: | , , , , , |
| Format: | clinical trial research Journal Article |
| Published: |
Springer Nature
Apr2017
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=121743092&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 121743092 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13871307 OHC jtl: Journal of Clinical Monitoring & Computing issn: 13871307 maglogo: N pubinfo: dt: Apr2017 vid: 31 iid: 2 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 121743092 121743092 NLM27072989 121743092 10.1007/s10877-016-9861-5 NLM27072989 121743092 ppf: 449 ppct: 9 formats: fmt: @attributes: type: P tig: atl: A head to head evaluation of 8 biochemical scanning tools for unmeasured ions. aug: au: Morgan, Thomas Anstey, Chris Wolf, Matthew Morgan, Thomas J Anstey, Chris M Wolf, Matthew B affil: Intensive Care Unit, Mater Research, Mater Health Services , University of Queensland , Salmon Building, Raymond Terrace South Brisbane 4101 Australia sug: subj: Acid-Base Equilibrium Blood Gas Analysis Equipment and Supplies Ions Blood Blood Gas Analysis Methods Acid-Base Imbalance Blood Chlorides Administration and Dosage Aged Albumins Analysis Sensitivity and Specificity Acetic Acid Blood Pharmacokinetics Aged, 80 and Over Hydrogen-Ion Concentration Female Sodium Administration and Dosage Adult Bicarbonates Administration and Dosage Linear Regression Models, Theoretical Time Factors Middle Age Young Adult Cardiopulmonary Bypass Methods Acids, Acyclic Blood Male ROC Curve Human Coenzymes Blood Clinical Trials Validation Studies Comparative Studies Evaluation Research Multicenter Studies Aged: 65+ years Aged, 80 & over Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: We aimed to evaluate the sensitivity and specificity of 8 biochemical scanning tools in signalling the presence of unmeasured anions. We used blood gas and biochemical data from 15 patients during and after cardio-pulmonary bypass. Sampling time-points were pre-bypass (T1), 2 min post equilibration with priming fluid containing acetate and gluconate anions (T2), late bypass (T3) and 4 h after surgery (T4). We calculated the anion gap (AG), albumin-corrected anion gap (AGc), whole blood base excess (BE) gap, plasma BE gap, standard BE gap and the strong ion gap (SIG), plus 2 new indices-the unmeasured ion index (UIX) and unmeasured plasma anions according to the interstitial, plasma and erythrocyte acid-base model (IPEua). Total measured plasma concentrations of acetate and gluconate [XA] were proxies for unmeasured plasma anions. [XA] values (mmol/L) were 1.41 (0.87) at T1, 11.73 (3.28) at T2, 4.80 (1.49) at T3 and 1.36 (0.73) at T4. Corresponding [albumin] values (g/L) were 32.3 (2.0), 19.8 (2.6), 21.3 (2.5) and 29.1 (2.3) respectively. Only the AG failed to increase significantly at T2 in response to a mean [XA] surge of >10 mEq/L. At an [XA] threshold of 6 mEq/L, areas under receiver -operator characteristic curves in rank order were IPEua and UIX (0.88 and 0.87 respectively), SIG (0.81), AGc (0.79), standard BE gap (0.77), plasma BE gap (0.71), BE gap (0.70) and AG (0.59). Similar ranking hierarchies applied to positive and negative predictive values. We conclude that during acute hemodilution UIX and IPEua are superior to the anion gap (with and without albumin correction) and 4 other indices as scanning tools for unmeasured anions. pubtype: Academic Journal doctype: clinical trial research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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