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急诊科低血压患者的即时床边血液分析。

Point-of-care blood analysis of hypotensive patients in the emergency department.

机构信息

Department of Emergency Medicine, College of Medicine, Hanyang University Guri Hospital, Guri, Republic of Korea.

Department of Emergency Medicine, College of Medicine, Hanyang University Guri Hospital, Guri, Republic of Korea.

出版信息

Am J Emerg Med. 2020 Jun;38(6):1049-1057. doi: 10.1016/j.ajem.2019.158363. Epub 2019 Jul 25.

Abstract

OBJECTIVE

The aim of this study is to compare a point-of-care (POC) analysis, Enterprise POC (epoc), using the capillary blood obtained from skin puncture with conventional laboratory tests using arterial and venous blood in hypotensive patients.

METHODS

This study was conducted at the emergency department of a tertiary care hospital between June and November 2018. 231 hypotensive patients were enrolled. Three types of blood samples (capillary blood from skin puncture and arterial and venous blood from blood vessel puncture) were collected and analyzed. We compared a total of 13 parameters (pH, pCO2, pO2, HCO3-, Ca2+, lactate, Na+, K+, Cl-, glucose, Hb, Hct, and creatinine) between the POC analysis and reference analyzers by performing the equivalence test and Bland-Altman plot analysis.

RESULTS

In hypotensive patients, with the exception of two parameters (pCO2, pO2), the pH, HCO3-, Ca2+, lactate, Na+, K+, Cl-, glucose, Hb, Hct, and creatinine parameters measured by the POC analysis were equivalent to or correlated with the reference values. In the patients with cardiac arrest group, nine parameters (pH, HCO3-, Ca2+, Na+, K+, glucose, Hb, Hct, and creatinine) analyzed by the epoc system were equivalent to the reference values.

CONCLUSION

Most parameters, except pO2, measured by the epoc system using the capillary blood in hypotensive patients were equivalent to or correlated with those measured by the reference analyzers.

摘要

目的

本研究旨在比较即时检验(POC)分析,即 Enterprise POC(epoc),使用皮肤穿刺获得的毛细血管血与低血压患者的动脉血和静脉血的常规实验室检测结果。

方法

本研究于 2018 年 6 月至 11 月在三级医院的急诊科进行。共纳入 231 例低血压患者。采集并分析了三种类型的血样(皮肤穿刺获得的毛细血管血、血管穿刺获得的动脉血和静脉血)。我们通过等效性检验和 Bland-Altman 图分析,比较了 POC 分析与参考分析仪之间共 13 个参数(pH、pCO2、pO2、HCO3-、Ca2+、乳酸、Na+、K+、Cl-、葡萄糖、Hb、Hct 和肌酐)的差异。

结果

在低血压患者中,除了两个参数(pCO2、pO2)外,POC 分析测量的 pH、HCO3-、Ca2+、乳酸、Na+、K+、Cl-、葡萄糖、Hb、Hct 和肌酐参数与参考值等效或相关。在心脏骤停组患者中,epoc 系统分析的九个参数(pH、HCO3-、Ca2+、Na+、K+、葡萄糖、Hb、Hct 和肌酐)与参考值等效。

结论

epoc 系统使用低血压患者毛细血管血测量的大多数参数(除 pO2 外)与参考分析仪测量的参数等效或相关。

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