Zaloga G P, Dudas L, Roberts P, Bortenschlager L, Black K, Prielipp R
Department of Anesthesia, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 25157-1009.
J Clin Monit. 1993 Nov;9(5):341-6. doi: 10.1007/BF01618676.
The objective of this study was to determine the accuracy of a near-patient blood gas and electrolyte analyzer when used by non-laboratory-trained clinicians in the critical care setting.
One hundred eighty-five blood samples (split samples) from 50 intensive care unit patients were analyzed by clinicians in the critical care environment using a near-patient blood gas and electrolyte analyzer (GEM Premier, Mallinckrodt Sensor Systems, Ann Arbor, MI). Near-patient measurements were compared with those obtained by laboratory technologists in an established intensive care unit laboratory.
There was good agreement between the near-patient analyzer and the laboratory for pH, PCO2, sodium, potassium, ionized calcium, and hematocrit. Bias and precision were 0.006 and 0.03 for pH, 0.03 and 0.34 kPa for PCO2, 0.78 and 2.61 mmol/L for sodium, -0.11 and 0.12 mmol/L for potassium, -0.007 and 0.05 mmol/L for ionized calcium, and -0.99 and 1.33% for hematocrit. Bias between the laboratory instrument and the bedside analyzer was small for PO2 (-0.56 kPa). However, precision between instruments was significantly higher (2.39 kPa for all PO2 values and 1.61 kPa for PO2 < or = 13 kPa).
The test instrument is accurate and reproducible when used in the clinical setting by non-laboratory-trained individuals. Non-laboratory-trained individuals can obtain laboratory results in the near-patient setting comparable to those obtained by trained laboratory technologists.
本研究的目的是确定在重症监护环境中，未经实验室培训的临床医生使用床边血气和电解质分析仪时的准确性。
50名重症监护病房患者的185份血样（分样）由重症监护环境中的临床医生使用床边血气和电解质分析仪（GEM Premier，马林克罗德特传感系统公司，密歇根州安阿伯）进行分析。将床边测量结果与在一家成熟的重症监护病房实验室中由实验室技术人员获得的结果进行比较。
床边分析仪与实验室在pH值、二氧化碳分压、钠、钾、离子钙和血细胞比容方面具有良好的一致性。pH值的偏差和精密度分别为0.006和0.03，二氧化碳分压为0.03和0.34 kPa，钠为0.78和2.61 mmol/L，钾为 -0.11和0.12 mmol/L，离子钙为 -0.007和0.05 mmol/L，血细胞比容为 -0.99和1.33%。实验室仪器与床边分析仪之间的氧分压偏差较小（-0.56 kPa）。然而，仪器之间的精密度显著更高（所有氧分压值为2.39 kPa，氧分压≤13 kPa时为1.61 kPa）。
该测试仪器由未经实验室培训的人员在临床环境中使用时准确且可重复。未经实验室培训的人员在床边环境中可获得与经过培训的实验室技术人员相当的实验室结果。
