Point-of-care blood analysis of hypotensive patients in the emergency department

Am J Emerg Med. 2020 Jun;38(6):1049-1057. doi: 10.1016/j.ajem.2019.158363. Epub 2019 Jul 25.

Abstract

Objective: The aim of this study is to compare a point-of-care (POC) analysis, Enterprise POC (epoc), using the capillary blood obtained from skin puncture with conventional laboratory tests using arterial and venous blood in hypotensive patients.

Methods: This study was conducted at the emergency department of a tertiary care hospital between June and November 2018. 231 hypotensive patients were enrolled. Three types of blood samples (capillary blood from skin puncture and arterial and venous blood from blood vessel puncture) were collected and analyzed. We compared a total of 13 parameters (pH, pCO2, pO2, HCO3-, Ca2+, lactate, Na+, K+, Cl-, glucose, Hb, Hct, and creatinine) between the POC analysis and reference analyzers by performing the equivalence test and Bland-Altman plot analysis.

Results: In hypotensive patients, with the exception of two parameters (pCO2, pO2), the pH, HCO3-, Ca2+, lactate, Na+, K+, Cl-, glucose, Hb, Hct, and creatinine parameters measured by the POC analysis were equivalent to or correlated with the reference values. In the patients with cardiac arrest group, nine parameters (pH, HCO3-, Ca2+, Na+, K+, glucose, Hb, Hct, and creatinine) analyzed by the epoc system were equivalent to the reference values.

Conclusion: Most parameters, except pO2, measured by the epoc system using the capillary blood in hypotensive patients were equivalent to or correlated with those measured by the reference analyzers.

Keywords: Capillary blood; Emergency medical services; Hypotension; Point-of-care systems.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Biomarkers / blood
  • Blood Gas Analysis / methods
  • Blood Pressure / physiology*
  • Creatinine / blood*
  • Electrolytes / blood*
  • Emergency Service, Hospital*
  • Female
  • Follow-Up Studies
  • Hemoglobins / metabolism*
  • Humans
  • Hypotension / blood*
  • Hypotension / diagnosis
  • Hypotension / physiopathology
  • Male
  • Point-of-Care Systems*
  • Prospective Studies
  • Reproducibility of Results

Substances

  • Biomarkers
  • Electrolytes
  • Hemoglobins
  • Creatinine