[通过动脉导管进行分析提取时最小可弃置体积的测量]

[Measurement of minimum disposable volume in the extraction of an analysis through an arterial catheter].

作者信息

Arias Rivera Susana, Conde Alonso Pilar, Sánchez Izquierdo Raquel, García Granell Carmen, Martín de la Torre Pérez-Cejuela José Antonio, Ortega Castro M Elena, Berlanga M Luz, Pascual Durán Tomás, Oña Compari Francisca, de la Cal Miguel Angel

机构信息

Servicio de Cuidados Intensivos, Unidad de Grandes Quemados, Hospital Universitario de Getafe, Getafe, Madrid, Spain.

出版信息

Enferm Intensiva. 2004 Jul-Sep;15(3):123-34. doi: 10.1016/s1130-2399(04)78153-5.

DOI:10.1016/s1130-2399(04)78153-5

PMID:15450152

Abstract

OBJECTIVE

Arterial catheters are used to extract blood samples. To maintain its permeability we use heparin solution, which may contaminate and alter the desired results. Our aim was to determine the volume of the minimum discards during blood extractions to avoid results that might be altered in the analysis of biochemistry.

MATERIAL AND METHODS

A prospective study was carried out in 18 beds intensive care unit. Patients with arterial catheter (Seldicath) were included, maintaining 500 UI of heparin in saline of 500 ml, at a pressure of 300 mmHg through pressurizer (Tycos). The dead space (DS) in the radial arterial system is 0.8 ml and 1 ml in the femoral. We analyzed the reliability of different discards comparing the following: 3 ml + DS, 7.5 ml + DS, 12 ml + DS and 16.5 ml + DS. The statistical analysis was carried out through ANOVA and t Student.

RESULTS

In biochemistry, significant differences were not found except for potasium (p< 0.001) with 3 ml+DS during control, although it is not clinically relevant [difference through = 0.1 mEq/l (DS 0.2)]. Significant differences in prothrombina (p = 0.004) were found in coagulation, comparing 3 ml+DS and 16.5 ml + DS and in cefaline, comparing 7.5 ml + DS (p< 0.0001) and 16.5 ml + DS. There were not significant differences in the studies of gases.

CONCLUSIONS

Our study shows that to reach a reliable analytical results, it is not necessary to discard more than 3 ml+DS in biochemistry and in blood gases, and to determine cefalina time would necessary to discard a minimum of 7.5 ml+DS.

摘要

目的

动脉导管用于采集血样。为保持其通畅性，我们使用肝素溶液，这可能会污染并改变预期结果。我们的目的是确定采血过程中最小弃血量，以避免生物化学分析结果可能出现的改变。

材料与方法

在一个拥有18张床位的重症监护病房进行了一项前瞻性研究。纳入使用动脉导管（Seldicath）的患者，通过加压装置（泰科思）在500 ml盐水中维持500 UI肝素，压力为300 mmHg。桡动脉系统的死腔（DS）为0.8 ml，股动脉为1 ml。我们通过比较以下几种情况分析了不同弃血量的可靠性：3 ml + DS、7.5 ml + DS、12 ml + DS和16.5 ml + DS。通过方差分析和t检验进行统计分析。

结果

在生物化学方面，除了对照期间3 ml + DS组的钾（p < 0.001）外，未发现显著差异，尽管在临床上不相关[差值 = 0.1 mEq/l（DS为0.2）]。在凝血方面，比较3 ml + DS和16.5 ml + DS时，凝血酶原时间有显著差异（p = 0.004）；在脑啡肽方面，比较7.5 ml + DS（p < 0.00 [此处原文有误，推测应为0.0001]）和16.5 ml + DS时有显著差异。在气体研究中未发现显著差异。