Abstract
Background. To address the cause(s) of the significant differences in chloride (Cl−) concentrations between point-of-care blood gas analyzers and central laboratory analyzers. Methods. Cl− concentrations measured simultaneously by a blood gas analyzer (ABL800 FLEX) and a central laboratory analyzer (Hitachi7600) were collected in patients with severe acidemia (pH < 7.20) (n = 32) and were examined for correlations between differences in Cl− and factors associated with the acid-base status. Cl− concentrations were measured with both analyzers for samples with different concentrations of lactate, inorganic phosphate, or bicarbonate (HCO3 −). Results. The differences in Cl− concentrations were correlated with HCO3 − concentrations (r = 0.72, P < 0.0001) and anion gap (r = 0.69, P < 0.0001). Only the addition of HCO3 − proportionately increased Cl− levels measured by a Hitachi7600, but it did not affect those measured by an ABL800FLEX. Conclusion. Cl− measurements with some analyzers may be influenced by HCO3 − concentrations, which could result in the observed discrepancies.
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