New whole blood analyzers and their impact on cardiac and critical care

Gerald J Kost, M. J. Mcqueen

Research output: Contribution to journalArticle

43 Scopus citations

Abstract

Miniaturized whole blood biosensors, patient-focused hospitals, and rising expectations of patients and physicians are shifting laboratory diagnostics to the point of care. Expanding transplantation and intensive care are increasing the need for rapid test results. Whole blood analysis improves accuracy, eliminates centrifugation, reduces response time, and conserves blood volume. Several hand-held, and over 20 portable or transportable whole blood instruments are now available. Criteria for instrument evaluation include test menus, point-of-care features, analysis time, on-site performance, and information integration. Whole blood analyzers measure several vital indicators (pO2, pCO2, pH, hematocrit, K+, Ca2+, Na+, Cl-, glucose, and lactate) simultaneously in less than 2 min with less than 200 μl of whole blood. Other in vitro tests are available (Mg2*, osmolality, CO2 content, urea nitrogen, βhydroxybutyrate, hemoglobin, coagulation) or under development (HCO3 - phosphorus). Some can be monitored in vivo (O2 saturation, pO2, pCO2, pH, glucose) or ex vivo. The clinical impact is demonstrated by ionized calcium, now established in importance for cardiac and neurologic problems, and ionized magnesium, a promising new measurement. The hybrid laboratory (a composite of conventional clinical laboratory and patient-focused testing), performance maps, and quality paths facilitate implementation of new whole blood analyzers for optimal support of cardiac and critical care, and improved patient outcomes (prospects).

Original languageEnglish (US)
Pages (from-to)153-202
Number of pages50
JournalCritical Reviews in Clinical Laboratory Sciences
Volume30
Issue number2
DOIs
StatePublished - 1993

Keywords

  • Biosensors
  • Hybrid laboratory
  • Ionized calcium
  • Ionized magnesium
  • Patient-focusing
  • Performance maps
  • Point-of-care testing
  • Quality paths

ASJC Scopus subject areas

  • Biochemistry, medical
  • Biochemistry, Genetics and Molecular Biology(all)
  • Clinical Biochemistry
  • Microbiology
  • Hematology
  • Immunology and Allergy
  • Pathology and Forensic Medicine
  • Radiology Nuclear Medicine and imaging

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