High altitude arterialised capillary earlobe blood gas measurement using the Abbott i-STAT
High altitude arterialised capillary earlobe blood gas measurement using the Abbott i-STAT
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DOI：
10.1136/jramc-2017-000902
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发表时间：
2018-09-01
影响因子：
--
通讯作者：
Clarke, S.
中科院分区：
文献类型：
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作者：
Lewis, Christopher T.;Malein, W. L.;Clarke, S.
前言极端环境下生理参数的测量对于提高高原反应的认识、预防和治疗是至关重要的。护理点测试便于在非专科和远程环境中进行调查，并且在临床环境中的实时结果在床边变得越来越受欢迎。动脉化的毛细血管耳垂血气在研究中被推荐作为动脉采样的有效替代。本研究旨在验证在高海拔地区获取和分析日常耳垂样本的可行性。方法2016年1月17日至24日，24名赴厄瓜多尔考察的参与者进行了每日耳垂血气测量，包括pH值、氧分压和二氧化碳分压至5043m。使用雅培I-STAT血气分析仪和G3+试剂盒对样本进行分析。结果23/24名参与者在护理点成功获得并分析了每日测量结果，耐受性良好，没有不良事件发生。12%(27/220)的采样盒不合格，需要重复采样。结论雅培I-STAT每日耳垂血气分析在高海拔环境下是可行的。参与者和设备应在测试前和测试期间保持温暖。应备有备用墨盒。这种方法可能对偏远、农村和荒野医学的研究和治疗措施都有用。
Introduction Measurement of physiological parameters in extreme environments is essential to advancing knowledge, prophylaxis and treatment of altitude sickness. Point-of-care testing facilitates investigation in non-specialist and remote settings, as well as becoming increasingly popular at the bedside for real-time results in the clinical environment. Arterialised capillary earlobe blood gases are recommended as a valid alternative to arterial sampling in research. This study aimed to test the feasibility of obtaining and analysing daily earlobe samples at high altitude.Methods From 17 to 24 January 2016, 24 participants on a research expedition to Ecuador underwent daily earlobe blood gas measurements including pH, partial pressure of oxygen and partial pressure of carbon dioxide to 5043m. Samples were analysed using an Abbott i-STAT blood gas analyser and G3+ cartridges.Results Daily measurements were successfully obtained and analysed at the point of care in 23/24 participants and were well tolerated with no adverse events. 12% (27/220) cartridges failed and required repeat sampling.Conclusions Daily earlobe blood gas analysis using the Abbott i-STAT is feasible in a protected environment at high altitude. Participants and equipment should be kept warm before and during testing. Spare cartridges should be available. This methodology may be useful for both research and therapeutic measurements in remote, rural and wilderness medicine.