Goundan Poorani Nallam, Willard Devina Luhur, Sahin-Efe Ayse, Fan Shu-Ling Liang, Alexanian Sara Michelle
Section of Endocrinology, Diabetes and Nutrition, Boston University School of Medicine, Boston University Medical Center, 720 Harrison Ave, Doctors Office Building, #8100, Boston, MA 02118, United States.
Department of Endocrinology, South Shore Health, Norwell, MA, United States.
J Clin Transl Endocrinol. 2019 Aug 16;18:100205. doi: 10.1016/j.jcte.2019.100205. eCollection 2019 Dec.
To determine if bicarbonate values from venous blood gas (VBG) and plasma chemistry samples provided agreement in determining the bicarbonate criteria for the diagnosis and/or resolution of diabetic ketoacidosis (DKA).
A retrospective chart review of data from patients admitted to a tertiary care hospital with a diagnosis of DKA over a four year period was performed. Paired bicarbonate values from a VBG and chemistry panel, if drawn within 60 minutes of each other, were compared.
At the time of diagnosis of DKA, 197 paired bicarbonate values were available for analysis with the mean difference between the two methods of testing of 2.5 mmol/L. 16 of the 197 (8%) paired values were discordant in meeting criteria for diagnosis of DKA. At the time of resolution of DKA, 83 paired bicarbonate samples were compared. The mean difference was 2.3 mmol/L. 20 of the 83 (24%) paired bicarbonate values showed discordance with regards to meeting the bicarbonate criteria for resolution of DKA.
Discordance between bicarbonate results from different analysis methods may lead to different determinations as to whether or not a patient meets the biochemical definition for diagnosis and resolution of DKA.
确定静脉血气（VBG）和血浆化学样本中的碳酸氢盐值在确定糖尿病酮症酸中毒（DKA）诊断和/或缓解的碳酸氢盐标准方面是否一致。
对一家三级护理医院在四年期间收治的诊断为DKA的患者的数据进行回顾性图表审查。比较了在彼此60分钟内采集的VBG和化学分析中的配对碳酸氢盐值。
在诊断DKA时，有197对配对的碳酸氢盐值可供分析，两种检测方法之间的平均差异为2.5 mmol/L。197对配对值中有16对（8%）在满足DKA诊断标准方面不一致。在DKA缓解时，比较了83对配对的碳酸氢盐样本。平均差异为2.3 mmol/L。83对配对的碳酸氢盐值中有20对（24%）在满足DKA缓解的碳酸氢盐标准方面存在不一致。
不同分析方法得出的碳酸氢盐结果之间存在差异，可能导致对于患者是否符合DKA诊断和缓解的生化定义有不同的判定。
