Impact of storage temperature and time before analysis on electrolytes (Na+, K+, Ca2+), lactate, glucose, blood gases (pH, pO2, pCO2), tHb, O2Hb, COHb and MetHb results
Author:
Puravet Antoine1, Rieu Benjamin1, Phere Camille1, Kahouadji Samy12ORCID, Pereira Bruno3, Jabaudon Matthieu12, Andanson Benjamin1, Brailova Marina1, Sapin Vincent12ORCID, Bouvier Damien124
Affiliation:
1. Biochemistry and Molecular Genetic Department , CHU Clermont-Ferrand , Clermont-Ferrand , France 2. Clermont Auvergne University, CNRS, INSERM, GReD , Clermont-Ferrand , France 3. Biostatistics Unit (DRCI) , CHU Clermont-Ferrand , Clermont-Ferrand , France 4. Service de Biochimie et Génétique Moléculaire, Centre de Biologie , CHU Gabriel Montpied , Clermont-Ferrand , France
Abstract
Abstract
Objectives
The objective of our study is to evaluate the effect of storage temperature and time to analysis on arterial blood gas parameters in order to extend the CLSI recommendations.
Methods
Stability of 12 parameters (pH, pCO₂, pO₂, Na+, K+, Ca2+, glucose, lactate, hemoglobin, oxyhemoglobin, carboxyhemoglobin, methemoglobin) measured by GEM PREMIER™ 5000 blood gas analyzer was studied at room temperature and at +4 °C (52 patients). The storage times were 30, 45, 60, 90 and 120 min. Stability was evaluated on the difference from baseline, the difference from the analyte-specific measurement uncertainty applied to the baseline value, and the impact of the variation on the clinical interpretation.
Results
At room temperature, all parameters except the lactate remained stable for at least 60 min. A statistically significant difference was observed for pH at T45 and T60 and for pCO2 at T60 without modification of clinical interpretation. For lactate, clinical interpretation was modified from T45 and values were outside the range of acceptability defined by the measurement uncertainty. All parameters except pO2 remained stable for at least 120 min at +4 °C.
Conclusions
A one-hour transport at room temperature is compatible with the performance of all the analyses studied except lactate. If the delay exceeds 30 min, the sample should be placed at +4 °C for lactate measurement. If the samples are stored in ice, it is important to note that the pO2 cannot be interpreted.
Publisher
Walter de Gruyter GmbH
Subject
Biochemistry (medical),Clinical Biochemistry,General Medicine
Reference44 articles.
1. Luukkonen, AAM, Lehto, TM, Hedberg, PSM, Vaskivuo, TE. Evaluation of a hand-held blood gas analyzer for rapid determination of blood gases, electrolytes and metabolites in intensive care setting. Clin Chem Lab Med 2016;54:585–94. https://doi.org/10.1515/cclm-2015-0592. 2. Bilan, N, Behbahan, AG, Khosroshahi, AJ. Validity of venous blood gas analysis for diagnosis of acid-base imbalance in children admitted to pediatric intensive care unit. World J Pediatr 2008;4:114–7. https://doi.org/10.1007/s12519-008-0022-x. 3. Gattinoni, L, Pesenti, A, Matthay, M. Understanding blood gas analysis. Intensive Care Med 2018;44:91–3. https://doi.org/10.1007/s00134-017-4824-y. 4. Glady, L, Moal, V, Benz-De Bretagne, I, Bouvier, D, Di Giovanni, F, Chenevier-Gobeaux, C, et al.. POCT-management during the first wave of Covid-19 in France. Results of a national survey leaded by the SFBC-POCT Working Group. Ann Biol Clin 2021;79:535–49. https://doi.org/10.1684/abc.2021.1685. 5. Krzych, L, Wojnarowicz, O, Ignacy, P, Dorniak, J. Be cautious during the interpretation of arterial blood gas analysis performed outside the intensive care unit. Acta Biochim Pol 2020;67:353–8. https://doi.org/10.18388/abp.2020_5178.
|
|