Alex C P, Manto J C, Garland J S
St. Joseph's Hospital, Milwaukee, Wis., USA.
J Perinatol. 1998 Jan-Feb;18(1):45-8.
The purpose of this study was to determine whether blood chemistry measurements obtained by a bedside blood analyzer through an umbilical artery catheter agreed with those obtained with use of conventional laboratory analyzers.
Forty-two neonates (1910 +/- 1000 gm) being treated in a level III neonatal intensive care unit had 88 blood samples drawn through an umbilical artery catheter. Serum sodium, potassium, glucose, and hematocrit concentrations were measured (n = 352) with use of a laboratory analyzer (0.7 ml of blood) and a bedside blood analyzer (0.06 ml of blood).
Only 5.7% of all measurement differences (20/352) were outside the predetermined clinically acceptable difference range, and just 1.4% (5/352) might have affected clinical decision making. Correlations between laboratory analyzer measurements and bedside blood analyzer measurements were excellent: serum potassium, r = 0.97, p = 0.0001; serum glucose, r = 0.93, p = 0.0001; and blood hematocrit, r = 0.93, p = 0.0001. Serum sodium measurement correlation was significant (p = 0.0001) but weaker (r = 0.86).
The bedside blood analyzer evaluated in this report is clinically useful for neonatal patients and could limit phlebotomy loss if used routinely.
本研究旨在确定通过脐动脉导管使用床边血液分析仪获得的血液化学测量值是否与使用传统实验室分析仪获得的测量值一致。
在三级新生儿重症监护病房接受治疗的42例新生儿（体重1910±1000克）通过脐动脉导管采集了88份血样。使用实验室分析仪（0.7毫升血液）和床边血液分析仪（0.06毫升血液）测量血清钠、钾、葡萄糖和血细胞比容浓度（n = 352）。
所有测量差异中仅有5.7%（20/352）超出预定的临床可接受差异范围，仅有1.4%（5/352）可能影响临床决策。实验室分析仪测量值与床边血液分析仪测量值之间的相关性极佳：血清钾，r = 0.97，p = 0.0001；血清葡萄糖，r = 0.93，p = 0.0001；血细胞比容，r = 0.93，p = 0.0001。血清钠测量相关性显著（p = 0.0001）但较弱（r = 0.86）。
本报告中评估的床边血液分析仪对新生儿患者具有临床实用性，如果常规使用可减少静脉穿刺失血。
