Department of Anesthesiology and Reanimation, Harran University Faculty of Medicine, Sanliurfa, Turkey.
Department of Medicinal Biochemistry, Harran University Faculty of Medicine, Sanliurfa, Turkey.
Comb Chem High Throughput Screen. 2020;23(8):827-831. doi: 10.2174/1386207323666200514072705.
In blood samples taken for testing purposes during drug infusion in the intensive care unit, there is a risk of interference due to drug-reactive interaction during the analysis.
A 19-year-old female patient had undergone surgery for intracranial astrocytoma, 12 years ago. Acinetobacter baumannii was found in the blood culture and deep tracheal aspiration fluid of the patient who had a fever (39.2 °C) with a body temperature during the follow-up. The patient was started on colistin 2 * 4.5 million IU. After the colistin infusion, biochemical tests were requested to control the patient's clinical situation. CK-MB mass and ProBNP values were measured in high concentrations. Cardiology consultation was requested to evaluate the increase in the CK-MB mass and ProBNP values. The patient's ECG and echocardiography showed no abnormality. The increase in cardiac markers was neither clinically acceptable nor insignificant. There was no hemolysis in the sample or analytical error in the device. Variability in the tests was thought to be due to the interference. As the bloodletting time was questioned, it was determined that it was taken during colistin treatment. In order to determine the effect of colistin-related interference on the other tests, the laboratory was contacted and additional tests (TSH, FT4, Anti- TPO, B-HCG, Estradiol, Prolactin, CA 125, CA 15-3, CA 19-9, Vitamin B12, C-Peptide, DDimer, PTH, 25 hydroxy vitamin D, PT, INR, APTT) were conducted. During colistin treatment, in many tests, bias was detected between -75 and + 268.80%.
Clinicians should consider suspicious test results that are incompatible with the diagnosis for the possibility of erroneous measurements due to colistin interference and review the sampling processes.
在重症监护病房进行药物输注时为检测目的而采集的血液样本中，由于分析过程中的药物反应性相互作用，存在干扰的风险。
一名 19 岁女性患者 12 年前因颅内星形细胞瘤接受了手术。在该患者出现发热（39.2°C）的随访过程中，血液培养和深部气管抽吸液中发现鲍曼不动杆菌。该患者开始接受多粘菌素 2 * 450 万 IU 的治疗。在输注多粘菌素后，请求进行生化检查以控制患者的临床情况。测定 CK-MB 质量和 ProBNP 值浓度较高。请心内科会诊以评估 CK-MB 质量和 ProBNP 值的升高。患者的心电图和超声心动图未见异常。该心脏标志物的增加既无临床意义，也非无足轻重。样本中无溶血或仪器分析错误。认为测试的变异性是由于干扰所致。由于质疑采血时间，确定是在多粘菌素治疗期间采集的。为了确定多粘菌素相关干扰对其他测试的影响，联系了实验室并进行了其他测试（TSH、FT4、抗 TPO、B-HCG、雌二醇、催乳素、CA 125、CA 15-3、CA 19-9、维生素 B12、C-肽、D-二聚体、PTH、25 羟基维生素 D、PT、INR、APTT）。在多粘菌素治疗期间，在许多测试中，检测到介于 -75 和 + 268.80%之间的偏差。
由于多粘菌素干扰，临床医生应考虑与诊断不符的可疑测试结果，可能是由于错误的测量，应审查采样过程。
