Is liquid heparin comparable to dry balanced heparin for blood gas sampling in intensive care unit?
Is liquid heparin comparable to dry balanced heparin for blood gas sampling in intensive care unit?
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DOI：
10.4103/0972-5229.125428
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发表时间：
2014-01
期刊：
影响因子：
--
通讯作者：
Goyal P
中科院分区：
文献类型：
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作者：
Chhapola V;Kumar S;Goyal P
在急诊室和重症监护室中，需要进行血气（BG）分析以管理危重患者。BG参数可能受到所用肝素制剂类型（液体肝素（LH）或干平衡肝素（DBH））的影响。本研究旨在确定使用DBH和LH进行的血气、电解质和代谢物估计是否具有可比性。一项前瞻性研究在一家三级医院的儿科重症监护室（PICU）进行。从35名连续儿童中采集配对静脉样本，分别置于市售DBH注射器和定制LH注射器中。立即通过血气分析仪分析样本，并比较pH、pCO 2、pO 2、HCO 3 −、Na+、K+、Cl-和乳酸盐。进行配对比较，并通过Bland-Altman差异图评估一致性。将95%绝对一致性限（LOA）与总允许误差（TEa）的质量标准进行比较。除pCO 2和K +外，所有测量参数的P值均具有显著性。与TEa相比，Bland-Altman差异图显示pCO 2、pO 2、HCO 3 −、Na+、K+和Cl−的LOA较宽。对于pCO 2、HCO 3 −、Na+、K+和Cl−，分别有40%、23%、77%、34%和54%的样本超出LH的TEa限值。我们的研究表明，LH和DBH之间BG参数pCO 2、pO 2、HCO 3-、K+、Na+和Cl−的一致性较差，因此不具有可比性。但是对于pH和乳酸，LH和DBH可以互换使用。
Blood gas (BG) analysis is required for management of critically ill patients in emergency and intensive care units. BG parameters can be affected by the type of heparin formulations used-liquid heparin (LH) or dry balanced heparin (DBH). This study was conducted to determine whether blood gas, electrolyte, and metabolite estimations performed by using DBH and LH are comparable. A prospective study was conducted at pediatric intensive care unit (PICU) of a tertiary care hospital. Paired venous samples were collected from 35 consecutive children in commercially prepared DBH syringes and custom-prepared LH syringes. Samples were immediately analyzed by blood gas analyzer and compared for pH, pCO2, pO2, HCO3−, Na+, K+, Cl-, and lactate. Paired comparisons were done and agreement was assessed by Bland-Altman difference plots. The 95% limits of absolute agreement (LOA) were compared with the specifications for total allowable error (TEa). The P values were significant for all measured parameters, with the exception of pCO2 and K +. Bland-Altman difference plots showed wide LOA for pCO2, pO2, HCO3−, Na+, K+, and Cl− when compared against TEa. For pCO2, HCO3−, Na+, K+, and Cl−, 40%, 23%, 77%, 34%, and 54% of samples were outside the TEa limits, respectively, with LH. Our study showed that there is poor agreement between LH and DBH for the BG parameters pCO2, pO2, HCO3-, K+, Na+, and Cl− and, thus, are not comparable. But for pH and lactate, LH and DBH can be used interchangeably.