The reproducibility of Stewart parameters for acid-base diagnosis using two central laboratory analyzers.

Ba-Vinh Nguyen 1, * Jean-Louis Vincent 2 Jean Baptiste Hamm Jean-Hervé Abalain 3 Jean-Luc Carré 4 Emmanuel Nowak 5 Mehdi Ould Ahmed Charles C Arvieux Gildas Gueret 6
* Auteur correspondant
1 Hôpital d'Instruction des Armées Clermont Tonnerre
2 Department of Intensive Care
3 JHA - Département de Biochimie et de Pharmaco-Toxicologie
4 Service de Biochimie et Biologie Moléculaire
5 CIC - Brest - Centre d'Investigation Clinique
6 CCTV - Brest - Service de chirurgie thoracique et cardio vasculaire [Brest]
Abstract : BACKGROUND: Acid-base derangements can be interpreted using the Stewart-Fencl approach, which includes calculation of the apparent strong ion difference (SID(app)), the effective SID (SID(eff)), and the strong ion gap (SIG). These calculations require the measurement of several variables. We hypothesized that the SID and SIG calculated by different analyzers would not be reproducible because of variability in the measured values. METHODS: In this prospective observational study conducted in a biochemistry laboratory, we analyzed 179 routine blood samples from consecutive patients over a 3-mo period using two automated blood chemistry analyzers, the LX20 (Beckman) and the Modular (Roche). Measured and calculated parameters from the two analyzers were compared. RESULTS: Although the correlation between measured values was satisfactory, there were large differences in the limits of agreement for calculated values (SID(app): 9.6 mEq/L, SID(eff): 6.4 mEq/L, and SIG: 11.7 mEq/L) and a weak correlation (SID(app): r(2) = 0.54 and SIG: r(2) = 0.12) between the analyzers. CONCLUSIONS: The results of the Stewart-Fencl approach for interpretation of acid-base status can vary according to the analyzer used. These differences may have important clinical and research implications..
Type de document :
Article dans une revue
Anesthesia and Analgesia, Lippincott, Williams & Wilkins, 2009, 109 (5), pp.1517-23. 〈10.1213/ANE.0b013e3181b62664〉
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http://hal.univ-brest.fr/hal-00758252
Contributeur : Ghislaine Calvez <>
Soumis le : mercredi 28 novembre 2012 - 13:52:37
Dernière modification le : mercredi 6 décembre 2017 - 10:34:01

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Ba-Vinh Nguyen, Jean-Louis Vincent, Jean Baptiste Hamm, Jean-Hervé Abalain, Jean-Luc Carré, et al.. The reproducibility of Stewart parameters for acid-base diagnosis using two central laboratory analyzers.. Anesthesia and Analgesia, Lippincott, Williams & Wilkins, 2009, 109 (5), pp.1517-23. 〈10.1213/ANE.0b013e3181b62664〉. 〈hal-00758252〉

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