Abstract
BackgroundNovel, portable blood gas analyzers (BGAs) may serve as essential point-of-care tools in remote regions, during air travel or in ambulance services but they have not been extensively validated.Research QuestionWe compared accuracy of a portable BGA to a validated stationary device.MethodsIn healthy individuals and patients with chronic obstructive pulmonary disease participating in clinical field studies at different altitudes, arterial blood samples were obtained at rest and during exercise in a hospital at 760 m and in a high altitude clinic at 3100 m. Paired measurements by a portable BGA (EPOC, Siemens Healthcare) and a stationary BGA (Rapidpoint500, Siemens Healthcare) were performed to compute bias (mean difference) and limits of agreement (95% CI of bias).ResultsOf 105 individuals, 248 arterial blood samples were analyzed, 108 at 760 m, 140 at 3100 m. Ranges of values measured by portable BGA were: pH 7.241−7.473, PaCO2 21.5−52.5 mmHg, and PaO2 45.5−107.1 mmHg. Bias (95% CI) between devices were: pH 0.007 (−0.029 to 0.044), PaCO2 −0.3 mmHg (−4.8 to 4.2), and PaO2 −0.2 mmHg (−9.1 to 4.7). For pH, agreement between devices was improved by the equation to correct pH by portable BGA = −1.37 + pHmeasured × 1.19; bias after correction −0.007 (−0.023 to 0.009). The portable BGA was easily handled and worked reliably.InterpretationAccuracy of blood gas analysis by the portable BGA in comparison to the reference BGA was adequate for clinical use. Because of portability and ease of handling, portable BGA are valuable diagnostic tools for use in everyday practice as well as under challenging field conditions.
Highlights
Mountain travelers as well as airplane passengers experience hypobaric hypoxia that may induce hypoxia-related illness and changes in metabolic conditions
The EPOC portable blood gas analyzer (BGA) has been evaluated in detail and proven to have high accuracy (Nichols et al, 2008; Nicolas et al, 2013; Stotler and Kratz, 2013; Luukkonen et al, 2016)
In 105 individuals, 248 radial artery blood samples were obtained for paired analyses by both devices, 108 at 760 m and 140 at 3100 m. 119 samples were collected at rest and 129 samples during exercise
Summary
Mountain travelers as well as airplane passengers experience hypobaric hypoxia that may induce hypoxia-related illness and changes in metabolic conditions. There is a lack of information about these health risks, partly due to the heavy weight of conventional diagnostic instruments for biochemical analysis of blood, the required external electrical power supply, and related major logistical efforts and costs. To address these issues, novel, portable devices for the analysis of blood gases, electrolytes and other parameters have been developed. The EPOC device (Siemens Healthcare) is a battery-operated, portable blood gas analyzer (BGA) for use in challenging pointof-care settings such as in remote mountain regions, during air travel, or in emergency ambulance services (Epocal Inc., 2020). Portable blood gas analyzers (BGAs) may serve as essential pointof-care tools in remote regions, during air travel or in ambulance services but they have not been extensively validated.
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