EVALUATE DISORDERS OF ARTERIAL BLOOD GASES AND ELECTROLYTES IN CRITICAL PATIENTS BY USING POINT-OF-CARE TESTING (POCT) IN EMERGENCY DEPARTMENT, CHORAY HOSPITAL

Abstract

Background: Study of disorders of arterial blood gases (ABG) and electrolytes in critical patients in emergency department has not been evaluated before in Vietnam. Detecting serious disorders, quickly and accurately diagnosing to make an effective treatment decision is an essential requirement. Objectives: This study aimed to evaluate disorders of arterial blood gases and electrolytes of critical patients and to find out the percentages of serious disorders in Emergency department, ChoRay hospital. Study design: A retrospective describes a series of cases. 203 patients classified with a “priority triage group 1”, being treated in Intensive care unit of Emergency department and had indications of doing ABG and electrolytes by POCT iSTAT® CG8 from 06/01/2016 to 08/31/2016 were surveyed in this study. Results: 203 cases were surveyed. Mean age was 50.2. 25-49 age group accounted for 74.8%, men/women was 1.26. Trauma/nontrauma was 1.13 with the rate of head trauma and respiratory diseases were high. Most of them were in shock condition. Most of trauma patients had normal ABGs when non-trauma patients had mixed acid-base disorders. Shock condition went with a high percentage of metabolic acidosis when non-shock condition went with a normal ABGs. Trauma patients had glycemia higher, kalemia lower than non-trauma patients.. Shock condition went with higher glycemia and lower natremia than non-shock condition. Upto 14.7% had PaO2 <40mmHg, 10.3% had pH<6,9 and 22.2% had pCO2>45mmHg. And 10.8% had glycemia <70mg/dl when 31% had glycemia >200mg/dl. Upto 11,8% Natremia <120mmol/l when 13.3% Natremia >160mmol/l. And 12.8% Kalemia <2.8mmol/l when 15.2% Kalemia >5.5mmol/l. Using POCT gave faster result-time: 2.67 minutes when medical costs are acceptable. Conclusion: Research results showed the percentages of serious disorders of ABG and electrolytes of critical patients in Emergency department, Cho Ray hospital and the essentials of using POCT to have faster results to get better treatments. Key words: Emergency medicine, ABG, Cho Ray Hospital