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VOLUME 20 , ISSUE 4 ( 2016 ) > List of Articles

RESEARCH ARTICLE

Are sodium and potassium results on arterial blood gas analyzer equivalent to those on electrolyte analyzer?

Shalini Gupta, Ashwani K. Gupta, Kamaljit Singh

Keywords : Arterial blood gas analyzer, direct ion selective electrode, electrolyte analyzer, electrolytes

Citation Information : Gupta S, Gupta AK, Singh K. Are sodium and potassium results on arterial blood gas analyzer equivalent to those on electrolyte analyzer?. Indian J Crit Care Med 2016; 20 (4):233-237.

DOI: 10.4103/0972-5229.180044

License: CC BY-ND 3.0

Published Online: 01-04-2016

Copyright Statement:  Copyright © 2016; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Objectives: The present study was conducted with the aim to compare the sodium (Na) and  potassium (K) results on arterial blood gas (ABG) and electrolyte analyzers both of which use direct ion selective electrode technology. Materials and Methods: This was a retrospective study in which data were collected for simultaneous ABG and serum electrolyte samples of a patient received in Biochemistry Laboratory during February to May 2015. The ABG samples received in heparinized syringes were processed on Radiometer ABL80 analyzer immediately. Electrolytes in serum sample were measured on ST-100 Sensa Core analyzer after centrifugation. Data were collected for 112 samples and analyzed with the help of Excel 2010 and  Statistical software for Microsoft excel XLSTAT 2015 software. Results: The mean Na level in serum sample was 139.4 ± 8.2 mmol/L compared to 137.8 ± 10.5 mmol/L in ABG (P < 0.05). The mean difference between the results was 1.6 mmol/L. Mean K level in serum sample was 3.8 ± 0.9 mmol/L as compared to 3.7 ± 0.9 mmol/L in ABG sample (P < 0.05). The mean difference between the results was 0.14 mmol/L. Statistically significant difference was observed in results of two instruments in low Na (<135 mmol/L) and normal K (3.5-5.2 mmol/L) ranges. The 95% limit of agreement for Na and K on both instruments was 9.9 to −13.2 mmol/L and 0.79 to −1.07 mmol/L respectively. Conclusions: The clinicians should be cautious in using the electrolyte results of electrolyte and ABG analyzer in inter exchangeable manner.


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  1. Polandic JE. Electrolytes. In: Bishop ML, Fody EP, Schoeff LE, editors. Clinical Chemistry Techniques, Principles and Correlation. 6 th ed. New Delhi: Wolters Kluwer; 2012. p. 357-83.
  2. Dimeski G, Morgan TJ, Presneill JJ, Venkatesh B. Disagreement between ion selective electrode direct and indirect sodium measurements: Estimation of the problem in a tertiary referral hospital. J Crit Care 2012;27:326.e9-16.
  3. Budak YU, Huysal K, Polat M. Use of a blood gas analyzer and a laboratory autoanalyzer in routine practice to measure electrolytes in intensive care unit patients. BMC Anesthesiol 2012;12:17.
  4. Jain A, Subhan I, Joshi M. Comparison of the point-of-care blood gas analyzer versus the laboratory auto-analyzer for the measurement of electrolytes. Int J Emerg Med 2009;2:117-20.
  5. Flegar-Mestric Z, Perkov S. Comparability of point-of-care whole-blood electrolyte and substrate testing using a stat profile critical care xpress analyzer and standard laboratory methods. Clin Chem Lab Med 2006;44:898-903.
  6. Nanda SK, Ray L, Dinakaran A. Agreement of arterial sodium and arterial potassium levels with venous sodium and venous potassium in patients admitted to intensive care unit. J Clin Diagn Res 2015;9:BC28-30.
  7. Medicare, Medicaid and CLIA programs; regulations implementing the clinical laboratory improvement amendments of 1988 (CLIA) - HCFA. Final rule with comment period. Fed Regist 1992;57:7002-186.
  8. Ladenson JH. Direct potentiometric measurement of sodium and potassium in whole blood. Clin Chem 1977;23:1912-6.
  9. Story DA, Morimatsu H, Egi M, Bellomo R. The effect of albumin concentration on plasma sodium and chloride measurements in critically ill patients. Anesth Analg 2007;104:893-7.
  10. Chacko B, Peter JV, Patole S, Fleming JJ, Selvakumar R. Electrolytes assessed by point-of-care testing - Are the values comparable with results obtained from the central laboratory? Indian J Crit Care Med 2011;15:24-9.
  11. Razavi S, Jafari A, Zaker H, Sadeghi A. Plasma and serum electrolytes levels correlation in the pediatric ICU. Tanaffos 2010;9:34-8.
  12. Chhapola V, Kanwal SK, Sharma R, Kumar V. A comparative study on reliability of point of care sodium and potassium estimation in a pediatric intensive care unit. Indian J Pediatr 2013;80:731-5.
  13. Chow E, Fox N, Gama R. Effect of low serum total protein on sodium and potassium measurement by ion-selective electrodes in critically ill patients. Br J Biomed Sci 2008;65:128-31.
  14. King R, Campbell A. Performance of the radiometer OSM3 and ABL505 blood gas analysers for determination of sodium, potassium and haemoglobin concentrations. Anaesthesia 2000;55:65-9.
  15. Wongyingsinn M, Suksuriyayothin S. Use of rapid ABG analyzer in measurement of potassium concentration: Does it agree with venous potassium concentration? J Med Assoc Thai 2009;92:925-9.
  16. van Berkel M, Scharnhorst V. Electrolyte-balanced heparin in blood gas syringes can introduce a significant bias in the measurement of positively charged electrolytes. Clin Chem Lab Med 2011;49:249-52.
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