Effect of syringe underfilling on the quality of venous blood gas analysis.

IF 2.2 Q2 MEDICINE, GENERAL & INTERNAL Diagnosis Pub Date : 2023-09-05 eCollection Date: 2024-02-01 DOI:10.1515/dx-2023-0096

Giuseppe Lippi, Laura Pighi, Marco Tosi, Marco Vettori, Giovanni Celegon, Emmanuel J Favaloro, Gian Luca Salvagno

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Abstract

Objectives: There is limited information on the influence of collecting small amounts of blood on the quality of blood gas analysis. Therefore, the purpose of this study was to investigate the effects of different degrees of underfilling of syringes on test results of venous blood gas analysis.

Methods: Venous blood was collected by venipuncture from 19 healthcare workers in three 1.0 mL syringes for blood gas analysis, by manually aspirating different volumes of blood (i.e., 1.0, 0.5 and 0.25 mL). Routine blood gas analysis was then immediately performed with GEM Premier 5,000. The results of the two underfilled syringes were compared with those of the reference syringe filled with appropriate blood volume.

Results: The values of most assayed parameters did not differ significantly in the two underfilled syringes. Statistically significant variations were found for lactate, hematocrit and total hemoglobin, the values of which gradually increased as the fill volume diminished, as well as for sodium concentration, which decreased in both insufficiently filled blood gas syringes. The bias was clinically meaningful for lactate in syringe filled with 0.25 mL of blood, and for hematocrit, total hemoglobin and sodium in both syringes containing 0.5 and 0.25 mL of blood.

Conclusions: Collection of smaller volumes of venous blood than the specified filling volume in blood gas syringes may have an effect on the quality of some test results, namely lactate, hematocrit, total hemoglobin and sodium. Specific indications must be given for standardizing the volume of blood to be collected within these syringes.

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注射器充气不足对静脉血气分析质量的影响。

目的：有关采集少量血液对血气分析质量的影响的信息十分有限。因此，本研究旨在探讨不同程度的注射器填充不足对静脉血气分析测试结果的影响：方法：通过静脉穿刺采集 19 名医护人员的静脉血，用三个 1.0 mL 注射器手动抽取不同体积的血液（即 1.0、0.5 和 0.25 mL）进行血气分析。然后立即使用 GEM Premier 5,000 进行常规血气分析。将两支未充分灌注的注射器的结果与注入适当血量的参照注射器的结果进行比较：结果：大部分检测参数的数值在两支充气不足的注射器中没有明显差异。乳酸、血细胞比容和总血红蛋白的数值随着充盈量的减少而逐渐增加，钠浓度也随着充盈量的减少而降低。在装有 0.25 毫升血液的注射器中，乳酸盐的偏差具有临床意义；在装有 0.5 毫升和 0.25 毫升血液的注射器中，血细胞比容、总血红蛋白和钠的偏差都具有临床意义：结论：采集的静脉血量少于血气分析仪规定的充盈量可能会影响某些检测结果的质量，如乳酸、血细胞比容、总血红蛋白和钠。必须给出具体说明，以规范这些注射器的采血量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diagnosis MEDICINE, GENERAL & INTERNAL-

CiteScore

7.20

自引率

5.70%

发文量

期刊介绍： Diagnosis focuses on how diagnosis can be advanced, how it is taught, and how and why it can fail, leading to diagnostic errors. The journal welcomes both fundamental and applied works, improvement initiatives, opinions, and debates to encourage new thinking on improving this critical aspect of healthcare quality.　 Topics: -Factors that promote diagnostic quality and safety -Clinical reasoning -Diagnostic errors in medicine -The factors that contribute to diagnostic error: human factors, cognitive issues, and system-related breakdowns -Improving the value of diagnosis – eliminating waste and unnecessary testing -How culture and removing blame promote awareness of diagnostic errors -Training and education related to clinical reasoning and diagnostic skills -Advances in laboratory testing and imaging that improve diagnostic capability -Local, national and international initiatives to reduce diagnostic error