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Electrolytes assessed by point-of-care testing - Are the values comparable with results obtained from the central laboratory?

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Author(s): Chacko Binila | Peter John | Patole Shalom | Fleming Jude | Selvakumar Ratnasamy

Journal: Indian Journal of Critical Care Medicine
ISSN 0972-5229

Volume: 15;
Issue: 1;
Start page: 24;
Date: 2011;
Original page

Keywords: Agreement | bland and altman | concordance | electrolytes | point-of-care testing

ABSTRACT
Background and Aims: When dealing with very sick patients, the speed and accuracy of tests to detect metabolic derangements is very important. We evaluated if there was agreement between whole blood electrolytes measured by a point-of-care device and serum electrolytes measured using indirect ion-selective electrodes. Materials and Methods: In this prospective study, electrolytes were analyzed in 44 paired samples drawn from critically ill patients. Whole blood electrolytes were analyzed using a point-of-care blood gas analyzer and serum electrolytes were analyzed in the central laboratory on samples transported through a rapid transit pneumatic system. Agreement was summarized by the mean difference with 95% limits of agreement (LOA) and Lin′s concordance correlation (p c). Results: There was a significant difference in the mean (±standard deviation) sodium value between whole blood and serum samples (135.8 ± 5.7 mmol/L vs. 139.9 ± 5.4 mmol/L, P < 0.001), with the agreement being modest (p c = 0.71; mean difference -4.0; 95% LOA -8.78 to 0.65). Although the agreement between whole blood and serum potassium was good (p c = 0.96), and the average difference small (-0.3; 95% LOA -0.72 to 0.13), individual differences were clinically significant, particularly at lower potassium values. For potassium values
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