1169 Impact of a Multiparameter Point-Ofcare Test (POCT) Analyzer on Bilirubin- Electrolyte Monitoring and Blood Transfusions in a Nicu

Abstract

Introduction: Since 2008, we introduced a multiparameter Point of Care testing (POCT) analyzer (Cobas-b221, Omni-S, Roche, Belgium). In comparison to central laboratory performed blood tests, POCT requires less blood (100-150 microL vs. 500 microL). Aim: To assess the impact of POCT on total number of tests performed and blood transfusions performed in our NICU. Methods: The number of bilirubin/ blood electrolyte tests performed by POCT and central laboratory performed tests were retrieved from the hospital information system. The number of tests and the number of transfusion were compared for the 2 periods, before (2006-2007) and after (2008-2009) introduction of POCT in the NICU. Results: While the laboratory performed electrolyte tests decreased from 6863 to 4673 (-32%) from period-1 to period-2, the total electrolyte tests performed increased from 7067 to 7771 (+10%). While the central laboratory tests for bilirubin decreased from 5177 to 3743 (-27,7%), the total bilirubin tests performed increased from 5196 to 6196 tests (+20%). The estimated blood volume loss decreased for bilrubin from 3055 ml to 2121 ml (-31%) and for electrolytes from 3455 mL to 2801 mL (-19%). The number of transfusion per infant decreased from 2.53 +/-; 4.0 to 1.57 +/-; 2.8 (change -48%, p = 0.014) in infants < 1500 g, from 0.19 +/-; 0.75 to 0.16 +/-; 0.65 (change -16%, p = 0.88) in those > 1500 g. Conclusion: Despite increased monitoring for bilirubin and electrolytes after introduction of POCT, there was a significant reduction in blood loss and blood transfusions in the NICU.