engleski

Repeating the critical values of COVID-19 patients on POCT analyzers expedites physician reporting

BACKGROUND-AIM: The monitoring of COVID-19 patients has become a global challenge in many clinical laboratories, and there is anincreasing incidence of critical values in laboratory results as compared to other patients in intensive care units. Criticalvalues represent those laboratory results that indicate a life-threatening condition of the patient, and it is commonpractice in many laboratories to repeat critical results before reporting the value to the physician. Such results shouldbe reported within 30 minutes of confirmation, and waiting for a re-measurement may delay reporting. METHODS: Since it was noticed that COVID-19 patients had the highest percentage of critical values for potassium (K), sodium(Na), chloride (Cl) glucose (Glc), and lactate (Lac), the aim of this summary was to compare results obtained primarilyon a biochemical (Beckman Coulter DxC 700 AU) and repeatedly on a less time- consuming POCT (Siemens RapidLab1265) analyzer. For this purpose, 40 serum samples were used for the determination of K, Na, Cl and Glc and 10 plasmasamples for the determination of Lac. Statistical comparison of the results was performed using Passing-Bablock (forelectrolytes and Glc) and Deming regression analysis (for Lac). RESULTS: Analysis of the results revealed neither proportional, nor constant error for K [y = -0.15 (-0.29-0.02) + 1.03 (0.99-1.07)x], Na [y = -4.08 (-15.47-5.19) + 1.03 (0.96-1.11) x], Cl [y = 5.00 (-2.96-5.00) + 1.00 (1.00-1.08) x], and Glc [y = -0.10(-0.24-0.04) + 1.00 (0.98-1.02) x] determination on a biochemical analyzer as compared to the POCT instrument. Also, no proportional error [y = 0.17 (0.07-0.27) + 1.06 (0.99-1.13) x] was found in the determination of Lac on a biochemical(CV = 1.79%) vs. POCT (CV = 4.37%) analyzer. Although a constant error was observed, it had no clinical significance(mean BIAS = -17.4% ; calculated RCV = +/-75.9%) CONCLUSIONS: In conclusion, repeating the critical values of K, Na, Cl, Glc, and Lac on the POCT rather than on the biochemical analyzeris justified because the analytical process for determination on the POCT analyzer takes much less time and the criticalresults are reported to the physician much earlier.

critical values ; COVID-19 ; POCT

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