Standardization of Blood gas analysis

本文对用张力法合成的人血、缓冲液型质控物质和有证参考物质作为血气分析的标准物质进行了评价和比较。这种材料的要求是稳定性和易于使用。经认证的参考材料在电极响应特性、血红蛋白含量、易于处理和追踪精确值的能力方面最适合于该目的。使用经认证的参考材料，与日本医学技术专家协会（石川，富山，和福井县。调查结果如下：1.虽然大多数分析仪都能正确测定pH和pCO_2，但pO_2测定值的变异性很大，特别是在高pO_2范围内。这种大的变异性的起源被认为是由于 关于我们 e在大于100 mmHg的压力范围内，氧解离曲线的斜率降低。因此，在2004年的环境质量评价中，将pO_2的规定值设置为较小的值，降低了pO_2测定值的变异性.根据各项目的实测值与规定值之间的关系，建立了校正方程。应用该方程可大大改善测量值的分布。我预计这个方程对常规测量也有同样的效果。评价了5种不同类型分析仪之间测量值的差异。每种类型的分析仪参加调查的人数都超过10人。不同类型分析仪测得的pH值具有统计学显著性，但差异较小，且在允许范围内。不同型号血气分析仪测定的pCO_2和pO_2值差异无统计学意义，说明有证标准物质对血气分析的标准化是最有用的。然而，当应用于包括新型传感器（如i-STAT）的设备时，材料显示出与全血不同的特性。在这方面应进行进一步的研究。少

As a standard material for blood gas analysis, several test samples including human blood synthesized with tonometry, buffer-type control materials for quality control, and the certified reference materials were evaluated and compared. The requisite for such material is the stability and easiness to use. The certified reference materials were best for that purpose with respect to the response characteristics to the electrodes, inclusion of hemoglobin, easy handling, and the ability to trace the exact values.Using the certified reference materials, external quality assurance (EQA) for blood gas analyzers have been executed in 2003 and 2004 in collaboration with Japanese Association of Medical Technologists in Ishikawa, Toyama, and Fukui prefectures. The results of this survey were as follows :1. While pH and pCO_2 were correctly measured in most analyzers, there was a large variability of measured pO_2 especially in high pO_2 range. The origin of this large variability was considered du … More e to the decreased slope of the oxygen dissociation curve in the pressure range more than 100 mmHg. In EQA in 2004, therefore, the specified value of pO_2 was set to a smaller one and the variability of the measured pO_2 values decreased.2. A correction equation was made from the relationship between measured and specified values in each item. The distribution of measured values was greatly improved by applying this equation. I anticipate the same effect of this equation on the routine measurements.3. The difference of measured values was evaluated between 5 different types of analyzers. The number attended to the survey was more than 10 in each type of analyzer. The measured pH values were statistically significant between the types of analyzers, but the differences were small and were in the permissible range. The measured pCO_2 and pO_2 values were not statistically significant between the different types of analyzers.In conclusion, the certified reference materials were considered to be most useful for standardization of blood gas analysis. However, the materials show different characteristics from whole blood when applied to the equipment including a new type of sensor such as i-STAT. Further studies should be conducted in this respect. Less