Article

Use of syringes containing dry (lyophilized) heparin in sampling blood for pH measurement and blood-gas analysis

Clinical Chemistry (Impact Factor: 7.91). 08/1982; 28(7):1727-9.
Source: PubMed

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    ABSTRACT: The purpose of this study was to determine the minimum amount of discard sample required to remove all heparinized normal saline from an indwelling arterial catheter to obtain an accurate arterial blood gas (ABG) sample. The pH and partial pressure of oxygen (PO2) and carbon dioxide (PCO2) were adjusted to known values prior to the onset of the study. The discard sample size ranged from zero to 5 cubic centimeters (cc), increasing at 0.5-cc increments. Twenty-nine sets of 11 consecutive discard/ABG samples, totaling 319 ABG specimens, were drawn over 20 minutes. Based on the data, a 2-cc discard is sufficient to guarantee accurate blood gases when withdrawing blood from an arterial catheter with a 1-cc dead space volume.
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    ABSTRACT: The effect of calcium-balanced heparin (471896, CIBA CORNING) on blood gas and electrolyte analysis was evaluated, by comparing with that of sodium heparin (Na heparin). One ml of whole blood was collected into a syringe, which contained calcium-balance heparin (Ca balanced heparin) or Na heparin. 122 pairs of blood samples obtained from 15 patients were analyzed for Na, K, ionized calcium (Ca(++)), total hemoglobin, pH, P(CO)(2), and P(O)(2) by an automatic blood gas and electrolyte analyzer, CIBA CORNING model 288. There was a significant difference ( P < 0.05) in pH, P(CO)(2), Na, and Ca(++) between the two different groups. Ca(++) concentration was significantly less in Na heparin group than in Ca balanced heparin group, probably due to more chelation of Ca(++) by Na heparin than Ca balanced heparin. The present study suggests that the Ca balanced heparin has minimal effect on the blood gas and electrolyte analysis, and is a suitable anticoagulant for the Ca(++) measurement.
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    ABSTRACT: The aim of this study was to test the hypothesis that differences in oxygen tension (PO2) and carbon dioxide tension (PCO2) values from measurements performed on different blood gas analysers in different laboratories are clinically insignificant. Samples of fresh whole human tonometered blood (PO2 8.1 kPa (60.8 mmHg); PCO2 5.3 kPa (39.9 mmHg)) were placed in airtight glass syringes and transported in ice-water slush. Blood gas analysis was performed within 3.5 h by 17 analysers (10 different models) in 10 hospitals on one day. The mean of the differences between the measured and target values was -0.01+/-0.19 and 0.21+/-0.13 kPa (-0.06+/-1.45 and 1.55+/-1.01 mmHg) for PO2 and PCO2, respectively. The mean of the differences between two samples on one analyser was 0.06+/-0.06 and 0.04+/-0.03 kPa (0.47+/-0.48 and 0.29+/-0.24 mmHg), respectively. For PO2 and PCO2 the interinstrument standard deviations (s(b)) were 0.18 and 0.13 kPa (1.38 and 0.99 mmHg), respectively, whereas the intra-instrument standard deviations (s) were 0.06 and 0.03 kPa (0.47 and 0.26 mmHg), respectively. Both for PO2 and PCO2 the ratios of s(b)2 and s2 were statistically significant (analysis of variance (ANOVA) p<0.001). The standard deviations of a random measurement on a random analyser were 0.19 and 0.14 kPa (1.46 and 1.02 mmHg) for PO2 and PCO2, respectively. We conclude that the variability in measurement of blood gas values among different blood gas analysers, although negligible, depends much more on inter- than intra-instrument variation, both for oxygen tension and carbon dioxide tension. Technical improvements and adequate quality control programmes, including tonometry, may explain why the variability in blood gas values depends mainly on errors in the pre-analytical phase.
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