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Scientific and technological research article

Vol. 21 No. 1 (2019)

Pre-analytical variables in blood arterial analysis in a third-level hospital institution in Cali, Colombia

DOI
https://doi.org/10.22267/rus.192101.139
Submitted
March 8, 2018
Published
2018-12-21

Abstract

Introduction: Several pre-analytical factors affect the results of blood gases. Objective: To evaluate the quality of the pre-analytical process of the blood arterial analyses requested in the critical and intermediate care units of a third-level hospital institution in the city of Santiago de Cali, Colombia. Materials and methods: A descriptive, transversal study was conducted. Applications and samples taken to hospitalized patients in critical care units were assessed. Measures of central tendency, standard deviation and distribution of proportions were calculated. The medians and Kruskal-Wallis tests allowed to evaluate statistically significant differences in the management of the sample per unit of service, shift, month, week of study. The analysis was performed in Stata 15®. Results: The effective sample was 414, which were taken to 125 patients. On average, 4 samples a day were taken for arterial studies. 100% of applications and samples did not meet the quality and safety criteria for patient identification and 3% met the technical criteria of temperature and time. Conclusions: The guidelines of the Ministry of Health for patient safety and the technical standards of pre-analytical quality in arterial are not fulfilled.

References

  1. Sánchez-Alarcos JM, Álvarez-Sala JL. Interpretación de la gasometría arterial. Medicine [Internet]. 2006; 9(68):4406-4409. Available from: https://www.sciencedirect.com/sdfe/pdf/download/eid/1-s2.0-S0211344906744459/first-page-pdf.
  2. Lippi G, Mattiuzzi C, Bovo Ch. Are we getting better at the preanalytical phase or just better at measuring it?. J Lab Precis Med [Internet]. 2018;3:11. Available from: http://jlpm.amegroups.com/article/view/3992/4746
  3. van Dongen-Lases EC, Cornes MP, Grankvist K, Ibarz M, Kristensen GB, Lippi G, Nybo M, Simundic AM; Working Group for Preanalytical Phase (WG-PRE), European Federation of Clinical Chemistry and Laboratory Medicine (EFLM). Patient identification and tube labelling - a call for harmonisation. Clin Chem Lab Med [Internet]. 2016;54(7):1141-5. Available from:https://www.degruyter.com/downloadpdf/j/cclm.2016.54.issue-7/cclm-2015-1089/cclm-2015-1089.pdf.
  4. Sintes N. Errores pre-analíticos en la extracción de una muestra para gasometría arterial. Revisión sistemática. Revista ASDEC [Internet]. 2018:(10):0. Available from: http://cursosfnn.com/articulo/errores-pre-analiticos-en-la-extraccion-de-una-muestra-para-gasometria-arterial-revision-sistematica/#resultados-y-discusion.
  5. Chhapola V, Kumar SA, Goyal P. Is liquid heparin comparable to dry balanced heparin for blood gas sampling in intensive care unit?. Indian Journal of Critical Care Medicine [Internet]. 2014;18(1):14-20. Available from:http://www.ijccm.org/temp/IJCCM18114-3459503_093635.pdf.
  6. Sareen R, Kapil M, Gupta GN. Preanalytical variables: Influence on laboratory results and patient care. Int J Clinicopathol Correl [Internet]. 2017;1:31-4. Available from: http://www.ijcpc.org/article.asp?issn=WKMP-0139;year=2017;volume=1;issue=1;spage=31;epage=34;aulast=Sareen.
  7. Mohammed H, Abdallah D. Easy blood gas analysis: Implications for nursing. Egyptian Journal of Chest Diseases and Tuberculosis [Internet]. 2016;65:369–376. Available from: https://core.ac.uk/download/pdf/82018845.pdf.
  8. Englezopoulou A, Kechagia M, Chatzikiriakou R, Kanellopoulou M, Valenti M and Masedu F. Pre Analytical Errors as Quality Indicators in Clinical Laboratory. Austin J Public Health Epidemiol [Internet]. 2016;3(5):8. Available from: file:///C:/Users/Usuario/Downloads/fulltext_ajphe-v3-id1048%20(1).pdf.
  9. Kumar A, Kushwah S, Sahay Sh. Effect of extra amount of heparin in syringe and its effect on arterial blood gas analysis. EJPMR [Internet]. 2015;2(6):290-293. Available from:http://www.ejpmr.com/admin/assets/article_issue/1447552403.pdf.
  10. Delost M. Blood gas and critical care analyte analysis. Chapter 6. [Internet]. Editorial Jones & Bartlett Learning. 2014. Available from: http://samples.jbpub.com/9781449652838/Chapter6.pdf.
  11. Baird G. Preanalytical considerations in blood gas analysis. Biochem Med (Zagreb) [Internet]. 2013;23(1):19–27. Available from:http://www.biochemia-medica.com/assets/images/upload/xml_tif/Baird_G_-Preanalytical_considerations_in_blood_gas_analysis.pdf.
  12. Dukić L, Milevoj L, Dorotić A, Baršić I. Blood gas testing and related measurements: National recommendations on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine. Biochem Med (Zagreb) [Internet]. 2016;26(3):318–336. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5082214/.
  13. Mohammadhoseini E, Safavi E, Seifi S, Seifirad S, Firoozbakhsh S, Peiman S. Effect of Sample Storage Temperature and Time Delay on Blood Gases, Bicarbonate and pH in Human Arterial Blood Samples. Iranian Red Crescent medical journal [Internet]. 2015;17(3):e13577.Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4441774/.
  14. Srisan P, Udomsri T, Jetanachai P, Lochindarat S, Kanjanapattanakul W. Effects of temperature and time delay on arterial blood gas and electrolyte measurements. J Med Assoc Thai. 2011;94(3 Suppl):S9-14.
  15. Hedberg P, Majava A, Kiviluoma K, Ohtonen P. Potential prenalytical errors in whole-blood analysis: effect of syringe sample volume on blood gas, electrolyte and lactate values. Scand J Clin Lab Invest [Internet]. 2009;69:585-591. Available from: https://www.tandfonline.com/doi/abs/10.1080/00365510902878716?journalCode=iclb20.
  16. García-García JA, Reding-Bernal A, López-Alvarenga JC. Cálculo del tamaño de la muestra en investigación en educación médica. Inv Ed Med [Internet]. 2013;2(8):217-224. Available from: http://riem.facmed.unam.mx/sites/all/archivos/V2Num04/07_MIE_CALCULO_DEL_TAMANO.PDF.
  17. República de Colombia. Ministerio de Salud. Guía de buenas prácticas para la seguridad del paciente en la atención en salud. Paquetes instruccionalespara la correcta identificación del paciente y de las muestras en el laboratorio clínico. Versión 2. Available from: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/CA/Guia-buenas-practicas-seguridad-paciente.pdf.
  18. Grupo de Trabajo de Seguridad del Paciente. Sociedad Española de Bioquímica y Patología Molecular. Estudio de la oxigenación e interpretación de la gasometría arterial. Documentos de la SEQC [Internet]. 2015:31-47. Available from: http://www.seqc.es/es/Comisiones/18/61/Grupo_de_Trabajo_sobre_Seguridad_del_paciente_%7C_Comite_Cientifico/.
  19. Sánchez VM, Muñoz MR, Chávez C, Guerrero I. Utilidad de los parámetros gasométricos como predictores de mortalidad en pacientes con choque séptico. Med Crit [Internet]. 2017;31(3):128-13. Available from: http://www.medigraphic.com/pdfs/medcri/ti-2017/ti173d.pdf
  20. Hawkins R. Managing the pre- and post-analytical phases of the total testing process. Lab Med [Internet].2012;32:5-1. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3255486/.
  21. Lippi G, Chiozza L, Mattiuzzi C, Plebani M. Patient and Sample Identification. Out of the Maze?. Journal of medical biochemistry [Internet]. 2017;36(2):107-112. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5471642/.
  22. National Committee for Clinical Laboratory Standards. NCCLS. Procedures for the Collection of Arterial Blood Specimens; Approved Standard—Fourth Edition. NCCLS document, H11-A4. Wayne, PA, USA: NCLSI; 2004.
  23. Plebani M. The detection and prevention of errors in laboratory medicine. Ann Clin Biochem. 2010;47:101-10.
  24. Mohammedsaleh ZM, Mohammedsaleh F. A Review Article of the Reduce Errors in Medical Laboratories. Glob J Health Sci [Internet]. 2015;7(1):46-51. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4796466/.
  25. Lippi G, Plebani M. Blood tubes should be labeled before drawing blood. Ann Blood [Internet]. 2017;2:18. Available from: http://aob.amegroups.com/article/view/4171/4901.
  26. Mahoney JJ, James A. Harvey, Wong RJ, Van Kessel AL. Changes in oxygen measurement when whole blood is stored in iced plastic syringe or glass syringes. Clin Chem. 1991;37(7):1244-48.
  27. Knowles TP, Mullin RA, Hunter JA, Douce FH. Effects of Syringe Material, Sample Storage Time, and Temperature on Blood Gases and Oxygen Saturation in Arterialized Human Blood Samples. RESPIRATORY CARE [Internet]. 2006;51(7):732-736. Available from: http://rc.rcjournal.com/content/51/7/732/tab-pdf
  28. Smajić J, Kadić D, Hasić S, Serdarević N. Effects of post-sampling analysis time, type of blood samples and collection tubes on values of blood gas testing. Med Glas (Zenica) [Internet]. 2015; 12(2):1-5. Available from: http://ljkzedo.ba/sites/default/files/unovombroju/13%20Smajic%20823%20A.pdf.
  29. Wagner D. The physiological basis of pulmonary gas exchange: implications for clinical interpretation of arterial blood gases. Eur Respir J [Internet]. 2015;45:227-243. Available from: http://erj.ersjournals.com/content/45/1/227.long.
  30. Chhapola V, Kumar SA, Goyal P. Is liquid heparin comparable to dry balanced heparin for blood gas sampling in intensive care unit?. Indian Journal of Critical Care Medicine [Internet]. 2014;18(1):14-20. Available from: http://www.ijccm.org/temp/IJCCM18114-3459503_093635.pdf.
  31. Kumar A, Kushwah S, Sahay Sh. Effect of extra amount of heparin in syringe and its effect on arterial blood gas analysis. EJPMR [Internet]. 2015;2(6):290-293. (Available from: http://www.ejpmr.com/admin/assets/article_issue/1447552403.pdf.
  32. Calaf N;Giner J. Comparison of arterial blood sample kits. Arch Bronconeumol. Arch Bronconeumol [Internet]. 2004;40(8):377-80. Available from: http://www.archbronconeumol.org/en-pdf-S1579212906603248.
  33. Lima-Oliveira G, Lippi G, Salvagno GL, Picheth MG,Guidi GC. Different manufacturers ofsyringes: A new source of variability in blood gas, acidâ base balance and related laboratory test?. Clinical Biochemistry. 2012;45(9):683-687.
  34. Youssef W, Yahia A,Shaaban N, Elhabashy S. Factors Affecting Validity of Arterial Blood Gases Results among Critically Ill Patients: Nursing Perspectives. Journal of Education and Practice. 2013;4(15):43-56.
  35. Figueroa-Montes LE. Gestión de riesgos en los laboratorios clínicos. Acta Med Per [Internet].. 2015;32(4):241-250. Available from: http://www.scielo.org.pe/pdf/amp/v32n4/a08v32n4.pdf

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