Clinical Usefulness of Point-of-care Test Chemistry Analyzer in Neonatal Intensive Care Unit
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: Point-of-care tests (POCTs) have the potential to significantly influence management of neonates. The aim of this study was to assess the clinical usefulness of the POCT chemistry analyzer in a neonatal intensive care unit (NICU). Methods: Blood samples of neonates admitted to the NICU were tested using a POCT chemistry analyzer (Piccolo Xpress Chemistry Analyzer, Abaxis, Union City, CA, USA) and a central laboratory chemical analyzer (Chemistry analyzer 7600-110, Hitachi Ltd., Tokyo, Japan) from March to September, 2010. Correlation of 15 analytes between the POCT and the central laboratory machine was evaluated. For consistency of the POCT, three consecutive samplings were performed. Differences among the three tests were recorded. The causes of performance errors were checked through log files. Results: One hundred of 112 pairs of tests for accuracy performed in 54 neonates showed a high correlation between the two machines. Twelve performance errors occurred during the 112 tests. The most common error was insufficient sample error. Eighteen triplet tests performed in 18 patients for consistency revealed a difference range of 3-10%, which was considered to be acceptable. No error occurred during the 54 tests. Conclusion: The POCT is capable of analyzing multiple analytes with a minimal amount of whole blood in a short time. The few performance errors noted presently are likely preventable. This POCT is concluded to be suitable for use as a simple and rapid diagnostic method in the NICU with a minimal amount of blood collected in a less invasive manner.
Abstract
Purpose: Point-of-care tests (POCTs) have the potential to significantly influence management of neonates. The aim of this study was to assess the clinical usefulness of the POCT chemistry analyzer in a neonatal intensive care unit (NICU). Methods: Blood samples of neonates admitted to the NICU were tested using a POCT chemistry analyzer (Piccolo Xpress Chemistry Analyzer, Abaxis, Union City, CA, USA) and a central laboratory chemical analyzer (Chemistry analyzer 7600-110, Hitachi Ltd., Tokyo, Japan) from March to September, 2010. Correlation of 15 analytes between the POCT and the central laboratory machine was evaluated. For consistency of the POCT, three consecutive samplings were performed. Differences among the three tests were recorded. The causes of performance errors were checked through log files. Results: One hundred of 112 pairs of tests for accuracy performed in 54 neonates showed a high correlation between the two machines. Twelve performance errors occurred during the 112 tests. The most common error was insufficient sample error. Eighteen triplet tests performed in 18 patients for consistency revealed a difference range of 3-10%, which was considered to be acceptable. No error occurred during the 54 tests. Conclusion: The POCT is capable of analyzing multiple analytes with a minimal amount of whole blood in a short time. The few performance errors noted presently are likely preventable. This POCT is concluded to be suitable for use as a simple and rapid diagnostic method in the NICU with a minimal amount of blood collected in a less invasive manner.
참고문헌 (17)
- Nichols JH, "Point of care testing", Clin Lab Med, 27, pp.893~908 (2007)
- 박현웅, "현장검사 화학 분석 장비 Piccolo xpress Chemistry Analyzer 성능 평가", Annals of Laboratory Medicine, 29(5), pp.430~438 (2009), 대한진단검사의학회
- Min WK, "The trend of clinical chemistry", Medical Postgraduates, 31, pp.251~254 (2003)
- Gill FN, "Case study: the pediatric unit. In Point-of-care testing. 1st ed", pp.405~428 (1999), Washington: AACC Press
- Cho SE, "Performance evaluation of the Hitachi 7600-110 chemistry autoanalyzer", Korean J Clin Pathol, 21, pp.331~337 (2001)
- Férard G, "Evaluation of immunonephelometry of C-reactive protein in serum", Clin Chem, 26, pp.782~783 (1980)
- Chang CW, "Evaluation of Hitachi 7600-110(R) for quantitative analysis of C-reactive protein", Korean J Clin Pathol, 20, pp.286~290 (2000)
- Park DW, "Comparison of the C- reactive protein measurement between nephelometry and fluorescence polarization immunoassay", J Clin Pathol Qual Control, 17, pp.197~203 (1995)
- Grützmeier S, "Four immunochemical methods for measuring C-reactive protein in plasma compared", Clin Chem, 35, pp.461~463 (1989)
- "Z-STATS 12: Correlation and simple least squares regression"[URL]
- Westgard JO, "Charts of operational process specifications ("OPSpecs charts") for assessing the precision, accuracy, and quality control needed to satisfy proficiency testing performance criteria", Clin Chem, 38, pp.1226~1250 (1992)
- Vanavanan S, "Performance of a multi-profile critical care testing analyzer", Clin Chem Lab Med, 46, pp.9~14 (2008)
- 이수연, "신생아중환자실에서의 i-STAT에 대한 임상적 평가", Annals of Laboratory Medicine, 24(3), pp.166~172 (2004), 대한진단검사의학회
- 임효빈, "미숙아에서 채혈을 위한 발뒤꿈치 천자시 두 종류 천자 기구의 비교", 대한신생아학회지, 17(2), pp.239~244 (2010), 대한신생아학회
- "Testing Cartridges for i-STAT system: A comprehensive menu of tests in a single platform"[URL]
- Flegar-Mestrić Z, "Comparability of point-of-care whole-blood electrolyte and substrate testing using a Stat Profile Critical Care Xpress analyzer and standard laboratory methods", Clin Chem Lab Med, 44, pp.898~903 (2006)
- Drenck N, "Point of care testing in Critical Care Medicine: the clinician's view", Clin Chim Acta, 307, pp.3~7 (2001)