在志愿者中对VIA V-ABG自动床边血气、化学和血细胞比容监测仪进行评估。

Evaluation in volunteers of the VIA V-ABG automated bedside blood gas, chemistry, and hematocrit monitor.

作者信息

Bailey P L, McJames S W, Cluff M L, Wells D T, Orr J A, Westenskow D R, Kern S E

机构信息

Department of Anesthesiology, University of Utah Health Sciences Center, Salt Lake City 84132, USA.

出版信息

J Clin Monit Comput. 1998 Jul;14(5):339-46. doi: 10.1023/a:1009991527491.

DOI:10.1023/a:1009991527491

PMID:9951759

Abstract

OBJECTIVE

To evaluate the VIA V-ABG (VIA Medical Corp.) point-of-care blood gas and chemistry monitor in healthy human volunteers, with particular emphasis on the measurement of blood gases.

METHODS

Experimental conditions were varied by intermittently subjecting volunteers to either isocapnic hypercapnia (end-tidal (ET), PETCO2 = 50+/-2 mmHg, ETPO2 = 130+/-5 mmHg) or isocapnic hypoxia (PETCO2 = 42+/-2, PETO2 + 45+/-2 mmHg) in addition to room air breathing. Measurements by the VIA V-ABG device were compared with paired samples and measurements performed by two ABL Radiometers (505 and 500). Analysis of results includes bias and precision plots and comparison of results with minimal performance criteria as established by CLIA.

RESULTS

Nineteen volunteers yielded 222 matched samples. The range of values were 7.32-7.61 for pH, 20.9-51.6 mmHg for PCO2, 27.9-184.5 mmHg for PO2, 134-141 mmol/l for Na, 3.1-4.1 mmol/l for K, and 30.0-50.4% for hematocrit. Bias and precision (+/-2 sd) for pH was 0.01 and 0.04, for PCO2 was 0.4 and 4.8, for PO2 was 1.0 and 17.0, for Na was -0.3 and 5.2, for K was 0.1 and 0.2, and for Hct was 2.0 and 5.4.

CONCLUSIONS

Over the range of blood gas values assessed, blood gas measurements by the VIA V-ABG device were clinically acceptable and met minimal performance criteria utilizing current Medicare CLIA proficiency standards. Performance criteria were also met by the VIA V-ABG device for Na, K, and Hct measurements but the range of values was too narrow to allow characterization of clinical acceptability. The VIA V-ABG device appears to perform well compared with the results which have been published for other point-of-care devices. Comparison between different studies investigating point-of-care devices is difficult due to several factors (range of values measured, comparison device, population studied, etc.). Some of these instruments, including the VIA V-ABG device, may serve quite well as point-of-care devices to perform certain tests at the bedside. Whether or not any of these devices can substitute for traditional laboratory blood gas and chemistry measurements remains an issue that is not adequately studied.

摘要

目的

在健康人体志愿者中评估VIA V - ABG（VIA医疗公司）即时检验血气和生化监测仪，尤其着重于血气测量。

方法

通过让志愿者间歇地吸入等容性高碳酸血症（呼气末（ET），呼气末二氧化碳分压（PETCO2）= 50±2 mmHg，呼气末氧分压（ETPO2）= 130±5 mmHg）或等容性低氧血症（PETCO2 = 42±2，动脉血氧分压（PETO2）= 45±2 mmHg），以及在室内空气中呼吸来改变实验条件。将VIA V - ABG设备的测量结果与配对样本以及两台ABL血气分析仪（505型和500型）的测量结果进行比较。结果分析包括偏差和精密度图，以及将结果与临床实验室改进修正案（CLIA）制定的最低性能标准进行比较。

结果

19名志愿者提供了222对匹配样本。pH值范围为7.32 - 7.61，PCO2为20.9 - 51.6 mmHg，PO2为27.9 - 184.5 mmHg，钠（Na）为134 - 141 mmol/L，钾（K）为3.1 - 4.1 mmol/L，血细胞比容为30.0 - 50.4%。pH的偏差和精密度（±2标准差）分别为0.01和0.04，PCO2为0.4和4.8，PO2为1.0和17.0，Na为 - 0.3和5.2，K为0.1和0.2，血细胞比容为2.0和5.4。

结论

在所评估的血气值范围内，VIA V - ABG设备的血气测量在临床上是可接受的，并且符合利用当前医疗保险CLIA熟练标准的最低性能标准。VIA V - ABG设备在测量Na、K和血细胞比容时也符合性能标准，但测量值范围过窄，无法确定其临床可接受性。与已发表的其他即时检验设备的结果相比，VIA V - ABG设备似乎表现良好。由于多种因素（测量值范围、比较设备、研究人群等），比较不同即时检验设备的研究存在困难。包括VIA V - ABG设备在内的一些此类仪器，作为即时检验设备在床边进行某些检测时可能表现良好。这些设备是否能替代传统实验室血气和生化测量仍是一个未得到充分研究的问题。