Acil Hemodiyaliz Endikasyonu Olan Hastalarda Hemoglobin, Hematokrit Ve Elektrolit Değerlerinin Venöz Kan Gazı Analizörü Ve Laboratuvar Oto Analizörleri İle Korelasyonu

Amaç: Bu çalışma ile, acil hemodiyaliz endikasyonu olan hastalarda venöz kanda ölçülen hemoglobin (Hb), hemotokrit (Hct) ve elektrolit değerlerini başucu kan gazı analizörü ve standart laboratuar oto analizörleri ile karşılaştırmayı, aralarındaki korelasyonu belirlemeyi ve özellikle de potasyum anormalliklerinde kan gazı cihazının etkinliğini araştırmayı amaçladık. Gereç ve Yöntemler: 01 Ocak 2017 ve 01 Kasım 2019 tarihleri arasında 18 yaşında veya daha büyük ve acil servisten acil hemodiyalize alınan hastalar çalışmaya dahil edildi. Laboratuar test sonuçlarına ulaşılamayan, laboratuar otoanalizörü ve venöz kan gazı analizörü ile analiz edilen kan örnekleri aynı anda alınmayan, venöz gaz sonuçları kan örneği alındıktan sonraki 30 dakikadan daha uzun sürede rapor edilen, test sonuçları hemolizli olan ve 18 yaşından küçük hastalar çalışma dışı bırakıldı. Başucu venöz kan gazı analizörü ve laboratuar otoanalizörleri ile ölçülen Hb, Hct, sodyum (Na), potasyum (K) ve klor (Cl) seviyeleri karşılaştırıldı.Bulgular: Çalışmaya 213 hasta dahil edildi. Başucu kan gazı analizörü ile laboratuar otoanalizörü sonuçları arasında korelasyon tespit edildi. Korelasyon katsayısı Na için 0.608, K için 0.821, Cl için 0.548, Hb için 0.738 ve Hct için 0.771 idi. En yüksek korelasyon K'da bulundu. Venöz kan gazı analizörü değerlerinden laboratuar analizörü değerlerini hesaplamak için formüller tasarlandı. Tasarlanan bu formüllerin her biri, çalışmaya dahil edilen hastalara uygulandı ve sonuçlar güvenilir bulundu. Sonuç: Acil serviste acil hemodiyaliz endikasyonu olan hastalarda venöz kan örneğinde başucu kan gazı analizörü ile ölçülen Na, K, Cl, Hb ve Hct değerleri ile laboratuar oto analizörlerinde ölçülen değerler aralarında korelasyon göstermektedir. Özellikle potasyum anormallikleri en yüksek korelasyon değerine sahiptir. Venöz kan örneğinde başucu kan gazı analizörü ile ölçülen Na, K, Cl, Hb ve Hct değerleri günlük uygulamada kullanılabilir. Ayrıca, bir laboratuar otomatik analizörü tarafından ölçülen değeri, bir kan gazı analizörü tarafından ölçülen değerden hesaplamak için formüller üretildi ve güvenliği test edildi. Bu formüller acil tedavi kararında fayda sağlayabilir.

Correlation of Hemoglobin, Hematocrit and Electrolyte Values with Venous Blood Gas Analyzer and Laboratory Auto Analyzers in Patients with Indications for Emergency Hemodialysis

Aim: The aim the study was to compare the hemoglobin (Hb), hematocrit (Hct) and electrolyte values measured in the venous blood by bedside blood gas analyzer and standard laboratory auto analyzers in patients with emergency hemodialysis indication, to determine the correlation between them and to investigate the accuracy of blood gas analyzer in K abnormalities.Methods: Patients aged 18 years and over who underwent emergency hemodialysis after being diagnosed in the ED between 01 January 2017 and 01 November 2019 were included in the study. Patients whose laboratory test results could not be reached, whose blood samples that analyzed by laboratory auto analyzer and venous blood gas analyzer were not collected simultaneously, whose venous gas results were reported more than 30 minutes after the blood sample was taken, showing hemolysis in laboratory tests and younger than 18-year-old were excluded from the study. The levels of Hb, Hct, sodium (Na), potassium (K) and chloride (Cl) measured by venous blood gas analyzer and laboratory auto analyzers were compared. Results: Two hundred and thirteen patients enrolled in the study. There was a correlation between blood gas analyzer and laboratory auto analyzer results. The correlation coefficient was 0.608 for Na, 0.821 for K, 0.548 for Cl, 0.738 for Hb and 0.771 for Hct. The highest correlation was in K. The formulas were designed to calculate laboratory analyzer values from venous blood gas analyzer values. Each of these formulas designed was applied to the patients included in the study and the results were found reliable. Conclusion: The values of Na, K, Cl, Hb and Hct measured by blood gas analyzer in venous blood sample are correlated with those measured in laboratory auto analyzers in patients with emergency hemodialysis indication in emergency department. Especially, K abnormalities have the highest correlation coefficient. The values of Na, K, Cl, Hb and Hct measured by blood gas analyzer in venous blood sample can be used in daily practice. Furthermore, formulas were able to be produced to calculate the value measured by a laboratory automatic analyzer from the value measured by a blood gas analyzer. These formulas can be useful in case of urgent decisions.

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