Interchangeability of Sodium and Potassium Result Values of Arterial Blood Gas with Laboratory Analyzer: Narrative Review

Üstündağ, Yasemin; Huysal, Kağan; Özgünay, Şeyda Efsun; Türkoğlu, Ali Rıza

doi:10.5005/jp-journals-10071-23110

Cited by 6 publications

(5 citation statements)

References 35 publications

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“… 12 It is worth mentioning that other factors such as dilution from heparin in syringes used to draw samples for blood gas analysis may contribute to differences between the methods. 13 …”

Section: Discussionmentioning

confidence: 99%

Different serum sodium assay, different model for end stage liver disease - sodium scores in patients awaiting liver transplant: A cross-sectional study

Rodriguez-Alvarez,

Moctezuma-Velázquez,

Mota-Ayala

et al. 2023

Ann Clin Biochem

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Introduction and aims: Sodium can be measured with direct or indirect methods, abnormal plasma total protein concentration can impact on sodium measured by indirect ion-selective electrodes (ISE). Serum sodium is an important item to determine the Model for End Stage Liver Disease Sodium (MELD-Na) score, commonly used for liver graft allocation. Patients with cirrhosis usually have hypoproteinemia. The aim of this study was to determine if there was a significant difference between the MELD-Na scores calculated based on the results of two different serum sodium ISE: indirect and direct. Methods: This was a retrospective study, we included 166 patients that underwent liver transplant assessment, and that had paired (i.e. same date and time) direct and indirect sodium determinations. We calculated the MELD-Na scores with both sodium determinations, and we compared them. Results: There was a significant difference between MELD-Na scores, the mean difference was 0.4+1.3. If MELD-Na score had been determined by the sodium measured by the direct ISE, 69 patients (42%) would have stayed in the same place on the waiting list, 67 patients (40%) would have moved up, and 30 patients (18%) would have moved down. Conclusions: There was a statistically significant difference between the MELD-Na scores calculated based on the two different sodium concentrations, which would theoretically result in changes in the order of the waiting list. This finding should prompt studies to assess if MELD-Na calculated based on direct methods has a better performance to predict clinically relevant outcomes.

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“… 12 It is worth mentioning that other factors such as dilution from heparin in syringes used to draw samples for blood gas analysis may contribute to differences between the methods. 13 …”

Section: Discussionmentioning

confidence: 99%

Different serum sodium assay, different model for end stage liver disease - sodium scores in patients awaiting liver transplant: A cross-sectional study

Rodriguez-Alvarez,

Moctezuma-Velázquez,

Mota-Ayala

et al. 2023

Ann Clin Biochem

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“…The discrepancy between the direct and indirect ISE methods is well established (9,13,14). Plasma is ∼93% water and 7% solids, and plasma electrolytes are almost entirely related to the aqueous component.…”

Section: Discussionmentioning

confidence: 99%

“…How physicians or patients should interpret these discrepancies and the consistency and comparability of the results between different testing systems remain unknown. Although previous literature has compared BGA and central laboratory biochemistry analyzers, most of the latter tests for electrolytes employ indirect ion-selective electrode (indirect ISE) and relatively limited numbers of samples were compared, with varying results (9,13,14). Moreover, very limited data are available regarding the consistency between the results of BGA and dry biochemistry analyzers when used together in the emergency laboratory setting.…”

Section: Introductionmentioning

confidence: 99%

Agreement of Potassium, Sodium, Glucose, and Hemoglobin Measured by Blood Gas Analyzer With Dry Chemistry Analyzer and Complete Blood Count Analyzer: A Two-Center Retrospective Analysis

Xie

Chen

et al. 2022

Front. Med.

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BackgroundBlood gas analyzers (BGAs) and dry biochemistry analyzers for potassium and sodium are based on direct electrode methods, and both involve glucose oxidase for glucose detection. However, data are lacking regarding whether the results of the two assay systems can be used interchangeably. In addition, there remains controversy over the consistency between BGA-measured hemoglobin and complete blood count analyzer data. Here, we compared the consistency of sodium, potassium, glucose, and hemoglobin levels measured by BGA and dry chemistry and complete blood count analyzers.MethodsData from two teaching hospitals, the Zhejiang Provincial People's Hospital (ZRY) and the Qianfoshan Hospital (QY), were retrospectively analyzed based on dry biochemistry and complete blood count analyzer results as the reference system (X) and BGA as the experimental system (Y). Plasma was used for biochemical analysis at the ZRY Hospital, and serum at the QY Hospital. Paired data from the respective hospitals were evaluated for consistency, and biases between methods were assessed by simple correlation, Passing–Bablok regression, and Bland–Altman analyses.ResultsThe correlations of potassium, sodium, glucose, and hemoglobin measured by BGA and dry biochemistry and complete blood count analyzers were high, at 0.9573, 0.8898, 0.9849, and 0.9883 for the ZRY Hospital and 0.9198, 0.8591, 0.9764, and 0.8666, respectively, for the QY Hospital. The results of Passing to Bablok regression analysis showed that the predicted biases at each medical decision level were within clinically acceptable levels for potassium, sodium, glucose, and hemoglobin at the ZRY Hospital. Only the predicted bias of glucose was below the clinically acceptable medical decision levels at the QY Hospital, while potassium, sodium, and hemoglobin were not. Compared with the reference system, the mean bias for BGA measurements at the ZRY Hospital was −0.08 mmol/L (95% confidence interval [CI] −0.091 to −0.069) for potassium, 1.2 mmol/L (95% CI 1.06 to 1.42) for sodium, 0.20 mmol/L (95% CI 0.167 to 0.228) for glucose, and −2.8 g/L for hemoglobin (95% CI −3.14 to −2.49). The mean bias for potassium, sodium, glucose, and hemoglobin at the QY Hospital were −0.46 mmol/L (95% CI −0.475 to −0.452), 3.7 mmol/L (95% CI 3.57 to 3.85), −0.36 mmol/L (95% CI −0.433 to −0.291), and −8.7 g/L (95% CI −9.40 to −8.05), respectively.ConclusionBGA can be used interchangeably with plasma electrolyte results from dry biochemistry analyzers but does not show sufficient consistency with serum electrolyte results from dry biochemistry analyzers to allow data interchangeability. Good consistency was observed between BGA and plasma or serum glucose results from dry biochemistry analyzers. However, BGA-measured hemoglobin and hematocrit assay results should be treated with caution.

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“…In practice, however, many clinicians are skeptical of ABG test results including K + , Na + , Hb, and HCT levels, arguing that these measurements are too unreliable to help make correct management decisions, 5 while some hold an opposite opinion. 6 , 7 , 8 Venous blood gas (VBG) is another method of assessing blood gas variables that is less painful and easier to perform than ABG.…”

Section: Introductionmentioning

confidence: 99%

Accuracy and stability evaluation of different blood sampling methods in blood gas analysis in emergency patients: A retrospective study

Zhao

Liu

Huang

et al. 2022

Clinical Laboratory Analysis

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Background To evaluate the accuracy and stability of arterial blood gas (ABG) results by comparison with venous measurements from routine blood tests, and to compare the accuracy and performance of two sampling syringes, pre‐heparinized syringe (PHS) and disposable arterial blood syringe (DABS), in ABG analysis. Methods We retrospectively analyzed the practical use of PHS and DABS in collecting ABG samples, involving 500 and 400 patients, respectively. For each patient, in addition to the ABG sample, a venous blood sample was also collected using a venous blood collection tube (VBCT) and used for routine blood tests. Accordingly, patients were referred to as the PHS + VBCT group and DABS + VBCT group. The correlation between arterial and venous values of each blood parameter in each group was evaluated using the interclass correlation coefficient (ICC). Bland–Altman was performed to evaluate the agreement between arterial and venous values and compare the performance of PHS and DABS in ABG sample collection. Results In the PHS + VBCT group, arterial K+, Na+, hemoglobin (Hb), and hematocrit (HCT) were 0.32 mmol/L, 2.90 mmol/L, 2.21 g/L, and 1.27% significantly lower their corresponding venous values while arterial Cl− was 7.60 mmol/L significantly higher than venous Cl−. In the DABS + VBCT group, arterial K+ and Na+ were 0.20 mmol/L and 1.19 mmol/L significantly lower while Cl− and HCT in arterial blood were 5.34 mmol/L and 0.66% significantly higher than their corresponding venous values. In both groups, arterial K+, Na+, Hb, and HCT values were highly consistent with their corresponding venous values, with all ICCs greater than 0.70, especially Hb and HCT. Bland–Altman analysis demonstrated that arterial K+ and Na+ were more consistent with venous counterparts in the DABS + VBCT group, with a narrower 95% limits of agreement than the PHS + VBCT group (K+, −0.7‐0.3 mmol/L vs. −1.1 to 0.5 mmol/L; Na+, −5.8 to 3.4 mmol/L vs. −8.2 to 2.4 mmol/L). Conclusion Arterial blood gas analysis of K+, Na+, Hb, and HCT using PHS or DABS for blood sampling is accurate and stable, especially DABS, which can provide clinicians with fast and reliable blood gas results.

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Interchangeability of Sodium and Potassium Result Values of Arterial Blood Gas with Laboratory Analyzer: Narrative Review

Cited by 6 publications

References 35 publications

Different serum sodium assay, different model for end stage liver disease - sodium scores in patients awaiting liver transplant: A cross-sectional study

Different serum sodium assay, different model for end stage liver disease - sodium scores in patients awaiting liver transplant: A cross-sectional study

Agreement of Potassium, Sodium, Glucose, and Hemoglobin Measured by Blood Gas Analyzer With Dry Chemistry Analyzer and Complete Blood Count Analyzer: A Two-Center Retrospective Analysis

Accuracy and stability evaluation of different blood sampling methods in blood gas analysis in emergency patients: A retrospective study

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