A review of temperature-related challenges and solutions for the Abbott i-STAT and Siemens Healthineers epoc devices

Füzéry, Anna K.; Elian, Fahed; Kost, Gerald J.

doi:10.1016/j.clinbiochem.2022.08.013

Cited by 6 publications

(4 citation statements)

References 32 publications

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“…Consequently, our results are not generalizable for use in the provision of care during emergency medical services calls, critical care transport or disaster relief missions. Indeed, others recently reported that the analytical performances of the i-STAT Alinity POC system changed in an environment with extreme temperatures [29]. Additionally, we performed the PT and INR tests on a neutral purge tube, which could have flawed the results of the PT and INR measurements due to blood dilution and/or the activation of coagulation in the tube before the test.…”

Section: Discussionmentioning

confidence: 99%

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Analytical Performances of the Novel i-STAT Alinity Point-of-Care Analyzer

et al. 2023

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Many Point-of-Care devices have been released over the past decade. However, data regarding their analytical performances in real-world situations remains scarce. Herein, we aimed to assess the analytical performances of the i-STAT Alinity system. We conducted an analytical performances study with the i-STAT Alinity device using cartridges CG4+ (pH, Pco2, Po2, lactate, bicarbonate and base excess); CHEM8+ (Na, K, Cl, ionized Ca, urea, creatinine, glucose, hematocrit and hemoglobin) and PT/INR (prothrombin time and international normalized ratio). We assessed the imprecision and compared the results to those obtained on existing instruments in the central laboratory. We found that the within-lab coefficients of variation (CV) were very low (<2%) or low (2–5%), except for creatinine and PT (CV = 5.2% and CV = 6.3%, respectively). For almost all the parameters, the results were strongly (R2 = 90–95%) or very strongly (R2 > 95%) correlated with those of the existing laboratory instruments, and the biases were very low (<2%) or low (2–5%). However, correlations of the PT and INR measurements with existing instruments were lower (R2 = 86.0% and 89.7%), and biases in the Po2 (7.9%), creatinine (5.4%) and PT (−6.6%) measurements were higher. The i-STAT Alinity appeared as a convenient device for measurements of numerous parameters. However, clinicians should interpret Po2, creatinine and PT results with caution.

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Section: Discussionmentioning

confidence: 99%

“…The following supporting information can be downloaded at: https:// www.mdpi.com/article/10.3390/diagnostics13020297/s1: Table S1: Review of the existing literature on the analytical performances of various Point-of-Care (POC) analyzers [2,4,7,12,21,22,[27][28][29][30][31][32][33][34][35][36][37][38].…”

Section: Supplementary Materialsmentioning

confidence: 99%

Analytical Performances of the Novel i-STAT Alinity Point-of-Care Analyzer

et al. 2023

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“…Manufacturers standardly issue requirements for operational and storage temperature and humidity. Exceeding these limits, even for brief periods of time, can render devices inoperable or produce clinically significant changes in POC test results [ 30 , 62 – 76 ]. This year, the International Federation of Clinical Chemistry Committee on POCT published guidelines for testing outside the hospital [ 77 ].…”

Section: Discussionmentioning

confidence: 99%

Using geographic rescue time contours, point-of-care strategies, and spatial care paths to prepare island communities for global warming, rising oceans, and weather disasters

Kost,

Füzéry,

Caratao

et al. 2023

Int J Health Geogr

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Objectives To perform geographic contour analysis of sea and land ambulance rescue times in an archipelago subject to super typhoons; to design point-of-care testing strategies for medical emergencies and weather disasters made more intense by global warming and rising oceans; and to assess needs for prehospital testing on spatial care paths that accelerate decision making, increase efficiency, improve outcomes, and enhance standards of care in island nations. Methods We performed needs assessments, inspected healthcare facilities, and collected ambulance rescue times from professionals in the Bantayan Archipelago, Philippines. We mapped sea/land ambulance rescue routes and time contours. To reveal gaps, we statistically compared the fastest and slowest patient rescue times from islands/islets and barangays to the District Hospital on Bantayan Island. We developed spatial care paths (the fastest routes to care) for acute myocardial infarction, community care, and infectious diseases. We generated a compendium of prehospital diagnostic testing and integrated outcomes evidence, diagnostic needs, and public health goals to recommend point-of-care strategies that build geographic health resilience. Results We observed limited access to COVID-19 assays, absence of blood gas/pH testing for critical care support, and spatial gaps in land and airborne rescues that worsened during inclement weather and sea swells. Mean paired differences (slowest-fastest) in ambulance rescue times to the District Hospital for both islands and barangays were significant (P < 0.0001). Spatial care path analysis showed where point-of-care cardiac troponin testing should be implemented for expedited care of acute myocardial infarction. Geospatial strengths comprised distributed primary care that can be facilitated by point-of-care testing, logical interisland transfers for which decision making and triage could be accelerated with onboard diagnostics, and healthcare networks amenable to medical advances in prehospital testing that accelerate treatment. Conclusions Point-of-care testing should be positioned upstream close to homes and island populations that have prolonged rescue time contours. Geospatially optimized point-of-need diagnostics and distributed prehospital testing have high potential to improve outcomes. These improvements will potentially decrease disparities in mortality among archipelago versus urban dwellers, help improve island public health, and enhance resilience for increasingly adverse and frequent climate change weather disasters that impact vulnerable coastal areas. [350 words].

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“…We hypothesized that there would be bias in the results of the POC devices compared to the results from the laboratory. This research was conducted in a tropical field setting where temperatures can exceed the operational temperature requirements of the POC devices, and various approaches have been described in the literature of ways to overcome such challenges [ 18 ]. Therefore, we further hypothesized that there would be differences in agreement based on study day due to daily differences in temperature.…”

Section: Introductionmentioning

confidence: 99%

Application and comparison of point-of-care devices for field evaluation of underlying health status of Guatemalan sugarcane workers

Krisher,

Jaramillo,

Dye-Robinson

et al. 2024

PLOS Glob Public Health

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With chronic disease prevalence on the rise globally, surveillance and monitoring are critical to improving health outcomes. Point-of-care (POC) testing can facilitate epidemiological research and enhance surveillance systems in limited resource settings, but previous research has identified bias between POC devices and laboratory testing. We compared the performance of two POC blood analyzers, the iSTAT handheld (Abbott, Princeton, NJ, USA) and the StatSensor Creatinine (Nova Biomedical, Waltham, MA, USA) to concurrent blood samples analyzed at a local laboratory that were collected from 89 agricultural workers in Guatemala. We measured creatinine and other measures of underlying health status with the POC and the lab blood samples. Pearson correlation coefficients, Bland-Altman plots, no intercept linear regression models and two-sample t-tests were used to evaluate the agreement between the POC and lab values collected across three study days and to assess differences by study day in a field setting. On average there was no observed difference between the iSTAT and lab creatinine measurements (p = 0.91), regardless of study day. Using lab creatinine as the gold standard, iSTAT creatinine results were more accurate compared to the Statsensor, which showed some bias, especially at higher values. The iSTAT had good agreement with the lab for sodium and blood urea nitrogen (BUN), but showed differences for potassium, anion gap, bicarbonate (TCO2), glucose, and hematocrit. In this tropical field setting, the research team devised a protocol to prevent the devices from overheating. In limited resource settings, POC devices carry advantages compared to traditional lab analyses, providing timely results to patients, researchers, and healthcare systems to better evaluate chronic health conditions. Technical challenges due to use of POC devices in high heat and humidity environments can be addressed using a standard protocol for transporting and operating the devices.

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A review of temperature-related challenges and solutions for the Abbott i-STAT and Siemens Healthineers epoc devices

Cited by 6 publications

References 32 publications

Analytical Performances of the Novel i-STAT Alinity Point-of-Care Analyzer

Analytical Performances of the Novel i-STAT Alinity Point-of-Care Analyzer

Using geographic rescue time contours, point-of-care strategies, and spatial care paths to prepare island communities for global warming, rising oceans, and weather disasters

Application and comparison of point-of-care devices for field evaluation of underlying health status of Guatemalan sugarcane workers

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