Blood gas analysis, more specifically referred to as arterial blood gas (ABG) analysis, is a standard clinical diagnostic test that measures a patient’s blood gases; oxygen and carbon dioxide blood gases constitute a delicate balance within the human body system. Arterial blood pH is included in these measurements because dissolved carbon dioxide acts to balance the acidity or alkalinity in the respiratory system. Similarly, bicarbonate balances pH in the renal system. Bicarbonate also functions as an indicator of metabolic balance.
Table 1 – Normal blood gas measurements1
Table 1 depicts common blood gas measurements and their normal range. Other parameters that can be tested in conjunction include electrolytes and metabolites. Blood gas analysis can not only ensure a patient’s health status, but can also diagnose respiratory, renal, or metabolic diseases affecting the normal balance of blood gases.
Blood gas analyzers
Figure 1 – IRMA TruPoint Blood Analysis System from ITC.
Since its discovery and development in the 1950s, blood gas analysis apparatus has evolved and revolutionized clinical diagnostics. Blood gas analyzers and automated blood gas systems are workhorses for clinical diagnostic laboratories. The following product showcase briefly outlines a sample of blood gas analyzers available in the market: http://www.labcompare.com/Clinical-Diagnostics/1579- Automated-Blood-Gas-Systems/ and http://www.labcompare.com/ Clinical-Diagnostics/1580-Blood-Gas-Analyzers/.
The IRMA TruPoint® Blood Analysis System from ITC (Edison, NJ) (Figure 1) is a lightweight, single-use cartridge system that provides results in 2 min. Seven different cartridges provide analysis for not only standard blood gas testing parameters, but also creatinine, lactate, and glucose.
Figure 2 – StatProfile pHOx Ultra from NovaBiomedical Corporation.
The StatProfile® pHOx® Series from Nova Biomedical Corporation (Waltham, MA) can perform 7500 tests and retain a full month’s supply of controls. This liquid-only calibration system utilizes small sample volumes, as low as 45 μL for a standard blood gas panel, and provides fast results in as little as 45 sec. Additionally, Nova Biomedical offers the StatProfile pHOx Ultra (Figure 2), which provides comprehensive analysis of up to 20 critical tests from one 210-μL sample in only 2 min. The 20 tests include: pH, pCO2, pO2, SO2%, Na+, K+, Ca++, Mg++, Cl–, glucose, BUN/urea, creatinine, lactate, Hct, Hb, O2Hb, HHb, COHb, MetHb, and tBil.
Figure 3 – RAPIDLab 1200 Blood Gas System from Siemens Healthcare Diagnostics.
Siemens Healthcare Diagnostics (Tarrytown, NY) offers various different blood gas systems to choose from. The RAPIDLab® 1200 Blood Gas System (Figure 3) is a cartridge-based system equipped with an extensive test menu, including co-oximetry panels. It is capable of running a full test menu analysis using only microsamples to deliver results in just 1 min.
ABL800 FLEX Blood Gas Analyzers from Radiometer Medical ApS (Brønshøj, Denmark) (Figure 4) measure various combinations of blood gas analysis and their equivalent oximetry, electrolyte, and metabolite parameters. With only one blood sample, the blood gas analyzer can run up to 18 STAT parameters. The automated benchtop blood gas analyzer can accommodate medium- to high-volume testing requirements.
Figure 4 – ABL800 FLEX Blood Gas Analyzers from Radiometer Medical ApS.
The cobas b 123 POC System from Roche Diagnostics (Indianapolis, IN) for hospital point of care features next-generation technology, a 15-parameter test menu, and lactate capability. Patented, thick-film sensor technology is another important facet of this point-of-care system.
Blood gas analysis apps
The following app showcase briefly outlines a few apps available in the iTunes and Android markets that support blood gas testing.
The Blood Gas Handbook
The Blood Gas Handbook app from Radiometer provides guidance and evaluation of blood gas parameters. The app allows you to add and edit individual parameters and reference intervals:
Radiometer also offers another app called the Blood Gas—Preanalytics app. This app provides a useful resource and best practices for preventing preanalytical errors during blood gas testing:
The ABG Guide app from Siemens Healthcare Diagnostics is an informational resource to facilitate decision-making in clinical practice. Not only does the app explain the parameters for blood gas testing, but it also provides suggested causes for various result values:
Blood gas method comparison
The Blood Gas—Preanalytics app from Radiometer is derived from an informative guide entitled “What to consider when performing method comparisons on blood gas analyzers.” Written by Gitte Wennecke,2 the guide outlines and discusses important preparatory considerations such as sample material, sample volume, interfering substances, and preanalytical considerations such as storage time, temperature, and evaporation, when performing blood gas analysis. In her article, Wennecke provides two practical checklists for the lab clinician.
Easy to operate and ready to use will remain key features of today’s latest blood gas analyzers. As the demand for point-of-care (POC) testing grows, clinicians will rely increasingly on performing fast and accurate blood gas analysis and other critical-care tests. Compare and learn more about blood gas analyzers and systems at www.labcompare.com: http://www.labcompare.com/Clinical-Diagnostics-Equipment/.
- MedlinePlus, 2013. Blood Gases. Retrieved from http://www.nlm. nih.gov/medlineplus/ency/article/003855.htm.
- Wennecke, G., 2003. What to consider when performing method comparisons on blood gas analyzers. Retrieved from http://acutecaretesting.org/en/articles/what-to-consider-when-performing-method-comparisons-on-blood-gas-analyzers.
Jeanely Hunt, MS, MBA, is Content Editor, American Laboratory/Labcompare; e-mail: [email protected].