J Korean Soc Emerg Med.  2017 Oct;28(5):431-440. 10.0000/jksem.2017.28.5.431.

Comparison of the Accuracy of Syringes Washed with Heparin, Manually and Heparin Coated Product for Arterial Blood Gas Analysis on Electrolytes and Hemoglobin

Affiliations
  • 1Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon, Korea. o1bin2@naver.com

Abstract

PURPOSE
The results of arterial blood gas analysis using conventional liquid sodium heparin syringes are inaccurate due to the dilution effect, chelation of heparin and the electrolyte, and interference of the heparin electrolyte measurement. This study compared the accuracy of using heparin with a liquid sodium heparin syringe (LHs) and balanced lithium/zinc heparin syringe (BHs).
METHODS
This study evaluated 6,778 cases who underwent an arterial blood gas test, serum electrolytes test, and complete blood count test among patients aged 18 years or older who visited the emergency room from November 1, 2016 to March 3, 2017. Finally, there were 2,383 cases using LHs and 2,584 cases using BHs. The results were compared between the groups using the LHs and BHs for sodium, potassium, and hemoglobin, and the agreement was compared using the Bland-Altman plot.
RESULTS
Sodium difference value was the 5.714±5.696 mmol/L in the LHs group, -1.549±3.339 mmol/L in the BHs group. The potassium difference value was -0.650±0.494 mmol/L (LHs group) and -0.257±0.367 mmol/L (BHs group). The hemoglobin difference values were -0.556±1.116 g/dL (LHs group) and -0.170±1.062 g/dL (BHs group). The results showed that the BHs group was improved compared to the LHs group (p<0.001).
CONCLUSION
The results of arterial blood gas analysis of sodium, potassium, and hemoglobin were more accurate for the BHs group than the LHs group based on the serum electrolytes and complete blood counts.

Keyword

Electrolytes; Sodium; Potassium; Hemoglobin; Heparin

MeSH Terms

Blood Cell Count
Blood Gas Analysis*
Electrolytes*
Emergency Service, Hospital
Heparin*
Humans
Potassium
Sodium
Syringes*
Electrolytes
Heparin
Potassium
Sodium
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