Comparison of electrolyte and glucose levels measured by a blood gas analyzer and an automated biochemistry analyzer among hospitalized patients

BACKGROUND: Blood gas analyzers are capable of delivering results on electrolytes and metabolites within a few minutes and facilitate clinical decision-making. However, whether the results can be used interchangeably with values measured by chemistry analyzers remains controversial. Blood gas analyzers are capable of delivering results on electrolytes and metabolites within a few minutes and facilitate clinical decision-making. However, whether the results can be used interchangeably with values measured by chemistry analyzers remains controversial. METHODS: In total, arterial and matched venous blood samples were collected from 200 hospitalized patients. Arterial blood samples were evaluated using a RAPIDPOINT 500 to test electrolyte and glucose levels, then the samples were centrifuged and the same parameters were measured with an AU5800. Venous blood samples were processed and tested in accordance with standard operation procedures. Data were compared by using a paired t test, the agreement between the two analyzers was evaluated by using the Bland-Altman test, and sensitivity and specificity were calculated. RESULTS: Paired t tests showed that all parameters tested were significantly different between the two analyzers except chloride. The biases calculated indicated that blood gas analyzers tend to underestimate the parameters, and the linear regression showed a strong correlation between the two analyzers. The sensitivity, specificity and kappa values demonstrated that the diagnostic performance of blood gas analyzers is not satisfactory. CONCLUSION: The significant reduction in parameter estimation and diagnostic performance we observed suggested that clinicians should interpret results from blood gas analyzers more cautiously. The reference interval of blood gas analyzers should be adjusted accordingly, given that values are underestimated.