Standardization of Blood gas analysis

作为血气分析的标准物质，对用眼压计合成的人血、缓冲型质控物质和标准物质进行了评价和比较。这种材料的必要条件是稳定性和易用性。在电极的响应特性、包含的血红蛋白、易操作和追踪精确值的能力方面，经认证的标准物质对于这一目的是最好的。使用经认证的标准物质，血气分析仪的外部质量保证(EQA)已于2003年和2004年与日本医疗技术协会在石川县、富山县和福井县进行了合作。本研究的结果如下：1.虽然大多数分析仪都能准确地测量pH和PCO_2，但测量的PO_2有很大的变异性，特别是在高PO_2范围内。这种巨大变化的起源被认为是Du…在100毫米汞柱以上的压力范围内，氧解离曲线的斜率减小。因此，在2004年的EQA中，将PO_2的规定值设定为较小的值，测量的PO_2值的变异性减小。根据各项目的实测值和规定值之间的关系，建立了校正方程。该方程的应用大大改善了实测值的分布。我预计这个方程在常规测量中也会有同样的效果。对5种不同类型分析仪的测定值差异进行了评价。参加调查的人数在每种类型的分析仪上都在10人以上。测得的pH值在不同类型的分析仪之间有统计学意义，但差异很小，在允许的范围内。不同类型血气分析仪的PCO_2和P_2O_2测定值差异无统计学意义，标准物质最适用于血气分析的标准化。然而，当应用于包括I-STAT等新型传感器的设备时，这些材料显示出与全血不同的特性。这方面还需要进一步研究。较少

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