Standardization of Blood gas analysis

作为血气分析的标准材料，对血气测量合成的人血、质控缓冲型对照材料、认证标准物质等几种检测样品进行了评价和比较。这种材料的先决条件是稳定和易于使用。经认证的标准物质在对电极的响应特性、包含血红蛋白、易于处理和追踪精确值的能力方面是最佳的。2003年和2004年，在石川县、富山县和福井县与日本医疗技术协会合作，使用经认证的参考物质，对血气分析仪实施了外部质量保证（EQA）。本次调查的结果如下：1。大多数分析仪的pH和pCO_2测量值都是正确的，但pO_2测量值的变异性较大，特别是在高pO_2范围内。这种大变异性的来源被认为是由于在超过100 mmHg的压力范围内，氧解离曲线的斜率下降。因此，在2004年的EQA中，pO_2的规定值被设置为较小的规定值，pO_2测量值的变异性减小。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。应用该方程后，测量值的分布得到了很大的改善。我预计这个方程对日常测量也会产生同样的影响。评估了5种不同类型分析仪之间测量值的差异。参加调查的人数在每种分析仪中都超过10人。测量的pH值在不同类型的分析仪之间具有统计学意义，但差异很小，并且在允许范围内。不同类型分析仪测定的pCO_2和pO_2值差异无统计学意义。综上所述，该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i-STAT等新型传感器在内的设备时，这些材料显示出与全血不同的特性。应在这方面进行进一步的研究。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