Plasma sodium measurements by direct ion selective methods in laboratory and point of care may not be clinically interchangeable.
An estimated 25 % of indirect ion selective electrode (ISE) ICU plasma sodium measurements differ from corresponding direct ISE values by at least 4 mmol/L, the dominant factor being indirect ISE over-estimation driven by hypoproteinemia. Since direct measurements are considered unaffected by protei...
| Publicado en: | Journal of Clinical Monitoring & Computing Vol. 31; no. 5; pp. 1103 - 1110 |
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| Autores principales: | , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Oct2017
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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=125148671&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 125148671 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13871307 OHC jtl: Journal of Clinical Monitoring & Computing issn: 13871307 maglogo: N pubinfo: dt: Oct2017 vid: 31 iid: 5 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 125148671 125148671 144022072 NLM27683272 10.1007/s10877-016-9938-1 NLM27683272 125148671 ppf: 1103 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Plasma sodium measurements by direct ion selective methods in laboratory and point of care may not be clinically interchangeable. aug: au: Weld, Brigit Morgan, Thomas Presneill, Jeffrey Weier, Steven Cowley, David Weld, Brigit A Morgan, Thomas J Presneill, Jeffrey J affil: Mater Health Services , Stanley Street, South Brisbane Brisbane 4101 Australia sug: subj: Sodium Blood Clinical Information Systems Hyponatremia Diagnosis Ions Reproducibility of Results Critical Care Diagnosis, Laboratory Linear Regression Reference Values Electrodes Intensive Care Units Scales ab: An estimated 25 % of indirect ion selective electrode (ISE) ICU plasma sodium measurements differ from corresponding direct ISE values by at least 4 mmol/L, the dominant factor being indirect ISE over-estimation driven by hypoproteinemia. Since direct measurements are considered unaffected by protein concentrations, we investigated whether direct ISE plasma sodium measurements in the laboratory and at point of care in ICU show sufficient agreement to be clinically interchangeable. From a 5 year clinical chemistry database, 9910 ICU plasma samples were assessed for agreement between direct ISE sodium measurements in ICU (ABL 700) and in the central laboratory (Vitros Fusion). The relationship between differences in paired plasma sodium measurements (Vitros-ABL) and total plasma protein concentrations was evaluated by generalized estimating equation linear regression. Patients were hypo-proteinemic [mean (SD) total protein concentration 56.9 (9.04) g/L]. Mean (SD) paired Vitros-ABL sodium measurements was -0.087 (1.74) mmol/L, range -14 to +10 mmol/L. Disagreement at ≥|4|mmol/L, ≥|3|mmol/L and ≥|2|mmol/L was present in 409 (4.1 %), 1333 (13.4 %) and 3591 (36.2 %) pairs respectively. Test-retest disagreement estimates within either source alone were substantially lower. Small negative Vitros-ABL differences associated with low plasma protein concentrations were reversed at high protein concentrations. Disagreement between plasma sodium concentrations monitored by two common direct ISE analyzers was substantially less than reported between direct and indirect ISE devices, although a protein influence of low clinical importance persisted. Disagreement was sufficient to jeopardize safe interchangeable interpretation in situations with a low tolerance for imprecision, such as hyponatremia correction. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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