Simultaneous measurements of blood pH, pCO₂, pO₂ and concentrations of hemoglobin and its derivates-A multicenter study

Abstract

During the last few years a need for simultaneous measurements of pH, pCO₂, pO₂, total hemoglobin concentration, oxygen saturation, carboxyhemoglobin, and methemoglobin has been emphasized. Besides the direct use of such measured quantities a series of algorithms has been developed, especially to describe series of oxygen parameters of the blood. A multicenter study involving 20 hospital centers in Denmark and Sweden was conducted. ABL^TM pH/blood gas analyzers and OSM^TM3 Hemoximeter^TMs from Radiometer A/S, Denmark were used. Each center was requested to perform daily quality control procedures using the Qualicheck^TM quality control system from Radiometer^TM. Blood samples were analyzed simultaneously on both types of analyzers using local procedures. During the study 11,700 blood data sets were collected.

The quality control procedures showed that the analyzers performed according to specifications with a few exceptions during the study. Measured values of hematocrit were obtained for some samples allowing for calculation of a regression equation for hematocrit and total hemoglobin. Average values for total hemoglobin from arterial and venous samples showed 7.2 mmol/L which is well below the typical normal value of 9.3 mmol/L. This was reflected in the calculated value for total oxygen (oxygen content).

The measured quantities made calculation of 2,3-diphosphoglycerate, cDPG, possible. Based on the DPG results, an internal quality procedure has been suggested.

Oxygen saturation was calculated based on actual values of pH and pO₂ and the standard oxyhemoglobin dissociation curve, and then compared to the measured oxygen saturation. The discrepancy between the calculated and measured values for the different types of blood samples showed that calculation of oxygen saturation should be used with great care for pO₂ values below 10 kPa and especially for capillary and umbilical blood samples.

ABL^TM, OSM^TM, Hemoximeter^TM, Radiometer^TM, and Qualicheck^TM are trademarks of Radiometer A/S, Denmark. ABL, OSM, Hemoximeter and Qualicheck are registered in the US and in some other countries.

Key Words:

• acid-base status
• blood gas
• blood pH
• pCO₂
• pO₂
• carboxyhemoglobin
• dyshemoglobins
• hemoglobin
• methemoglobin
• multicenter study
• oxygen
• oxygen saturation
• oxyhemoglobin
• p50.