![]() ![]() However, when solids account for >7% of total plasma, a concomitant decrease in the aqueous fraction occurs, so now the plasma aliquot obtained for dilution contains less water per unit volume and hence, less sodium per unit volume. A fixed volume of diluent is always used, and PNa is then calculated assuming a normal distribution between aqueous and solid phases. In indirect ISE, sodium concentration is measured in total plasma which is diluted before measurement occurs to reduce the volume of blood needed for analysis. ISE can be used with two different methods: direct and indirect. Sodium concentration in most clinical laboratories is measured by the ion selective electrode (ISE) technique, where a sodium-selective membrane is immersed into whole blood or plasma, and the ionic activity of sodium is measured, which is then converted to a readout concentration. Normal saline (NaCl 0.9%) has a sodium concentration of 154 mEq/L and approximates the physiologic concentration of sodium in plasma water. ![]() Awareness and recognition of spurious electrolyte and acid-base disorders can prevent unnecessary and harmful treatments. Use this portable and battery- or AC-operated analyzer wherever you need it - in the practice or in the field. Get results in two minutes from venous or arterial whole blood samples with single-use cassettes. Make more informed and confident fluid therapy choices. We present a narrative review of commonly reported pseudo-electrolyte disorders and describe strategies to exclude erroneous interpretations of these laboratory values and avoid pitfalls. Fast and accurate results for electrolytes, blood gases and more. It is also important that factors influencing these spurious results be recognized, and steps are taken to minimize them. Correctly interpreting these artifactual laboratory abnormalities is imperative as it might avoid unnecessary and potentially harmful interventions for the cancer patient. Examples of spurious derangements include pseudohyponatremia, pseudohypokalemia, pseudohyperkalemia, pseudohypophosphatemia, pseudohyperphosphatemia, and artifactual acid-base abnormalities. There are several electrolytes that can be artifactually increased or decreased serum electrolyte values that do not correspond to their actual systemic levels, potentially resulting in extensive diagnostic investigations and therapeutic interventions. However, spurious electrolyte disorders can complicate the interpretation and management of these patients. 40th Anniversary Special Collection: Kidney TransplantationĮlectrolyte and acid-base disorders are frequently encountered in patients with malignancy, either due to cancer itself or as a complication of its therapy. ![]() 40th Anniversary Special Collection: CKD.Clinicians should not use the i-STAT(®) Hb in isolation for clinical decision-making when considering blood transfusion in a situation of 25% or greater blood loss.īlood loss haemoglobin measurement point-of-care. The standard deviation of i-STAT(®) Hb was greater after ≥25% estimated total blood volume loss. The i-STAT(®) Hb had an acceptable coefficient of variation, but the Hb levels were lower than those estimated by the laboratory. There was poor correlation between total plasma protein and bias in i-STAT(®) measurements. The mean total plasma protein difference (total plasma protein T=0 minus T=1) was 13.6 g/l (95% confidence interval 10.2 to 17.0). ![]() The mean difference between i-STAT(®) and laboratory Hb was -7.6 g/l (standard deviation 6.5) at T=0 and -5.1 g/l (standard deviation 12) at T=1. The coefficient of variation of the paired i-STAT(®) Hb estimates was 2.8% and 2.9% at T=0 and T=1, respectively. Blood tests for i-STAT(®) Hb, laboratory Hb (Sysmex XE-2100(™), Sysmex Corporation, Kobe, Japan) and total plasma proteins were obtained at the start of surgery (T=0) and when an estimated 25% total blood volume loss had occurred (T=1). We investigated the accuracy of i-STAT(®) (Abbott Point of Care Inc., Princeton, NJ, USA) haemoglobin (Hb) measurement in surgical patients with an estimated blood loss of ≥25% of total blood volume. ![]()
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