Center of Clinical Laboratory, School of Medicine, Zhongshan Hospital, Xiamen University, Xiamen, China.
Department of Medical Laboratory, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, China.
J Clin Lab Anal. 2020 Jul;34(7):e23291. doi: 10.1002/jcla.23291. Epub 2020 Mar 9.
Blood gas analyzers are capable of delivering results on electrolytes and metabolites within a few minutes and facilitate clinical decision-making. However, whether the results can be used interchangeably with values measured by chemistry analyzers remains controversial. Blood gas analyzers are capable of delivering results on electrolytes and metabolites within a few minutes and facilitate clinical decision-making. However, whether the results can be used interchangeably with values measured by chemistry analyzers remains controversial.
In total, arterial and matched venous blood samples were collected from 200 hospitalized patients. Arterial blood samples were evaluated using a RAPIDPOINT 500 to test electrolyte and glucose levels, then the samples were centrifuged and the same parameters were measured with an AU5800. Venous blood samples were processed and tested in accordance with standard operation procedures. Data were compared by using a paired t test, the agreement between the two analyzers was evaluated by using the Bland-Altman test, and sensitivity and specificity were calculated.
Paired t tests showed that all parameters tested were significantly different between the two analyzers except chloride. The biases calculated indicated that blood gas analyzers tend to underestimate the parameters, and the linear regression showed a strong correlation between the two analyzers. The sensitivity, specificity and kappa values demonstrated that the diagnostic performance of blood gas analyzers is not satisfactory.
The significant reduction in parameter estimation and diagnostic performance we observed suggested that clinicians should interpret results from blood gas analyzers more cautiously. The reference interval of blood gas analyzers should be adjusted accordingly, given that values are underestimated.
血气分析仪能够在数分钟内提供电解质和代谢物的检测结果，有助于临床决策。然而，其检测结果是否可与化学分析仪测量值互换仍存在争议。血气分析仪能够在数分钟内提供电解质和代谢物的检测结果，有助于临床决策。然而，其检测结果是否可与化学分析仪测量值互换仍存在争议。
共采集 200 例住院患者的动脉和配对静脉血样。使用 RAPIDPOINT 500 对动脉血样进行电解质和葡萄糖水平检测，然后对样本进行离心，使用 AU5800 检测相同参数。按照标准操作规程处理和检测静脉血样。采用配对 t 检验比较数据，采用 Bland-Altman 检验评估两种分析仪之间的一致性，并计算灵敏度和特异性。
配对 t 检验显示，两种分析仪检测的所有参数均有显著差异，除氯外。计算出的偏差表明血气分析仪倾向于低估参数，线性回归显示两种分析仪之间具有很强的相关性。灵敏度、特异性和kappa 值表明血气分析仪的诊断性能不理想。
我们观察到参数估计和诊断性能显著降低，建议临床医生更谨慎地解释血气分析仪的结果。鉴于值被低估，血气分析仪的参考区间应相应调整。
