The results of a blood gas analysis provide physicians with clinically valuable information that helps answer a host of questions about a patient’s condition. What is the patient’s respiratory status? How effectively are the lungs delivering oxygen to the blood? How efficiently are they eliminating carbon dioxide? If the patient is on oxygen therapy, is delivery at appropriate levels? How well are the lungs and kidneys functioning together? Does the patient require immediate treatment for an acid-base imbalance?
Today’s blood gas analyzers are built to act fast with new features enhancing the usefulness of a system, from automated preanalytical and postanalytical steps to expanded menus. One system’s CO-oximetry module measures both hemoglobin derivatives and bilirubin using spectrophotometry and an accepted mathematical algorithm to eliminate interference and inaccurate values. Acid-based map trending and patient trending of single-test parameters are also new. Previous advances have included the addition of electrolytes and hemoglobin derivatives measurement, digital elements, liquid calibration, and smart reagents.
As showcased with the following instruments, manufacturers continue to expand the clinical usefulness of their blood gas analyzers, with next-generation analyzers featuring broader test menus, automation, ease of use, and smaller sample requirements, as well as applications that help hospitals improve patient care while decreasing the need for maintenance.
Abbott Diagnostics: i-Stat
Feature-rich and fully portable
The i-Stat portable clinical analyzer from Abbott Diagnostics, Abbott Park, Ill, can help the laboratory optimize its partnerships with critical care and emergency departments. The i-Stat is a true point-of-care analyzer designed to be used at the patient’s bedside for critical care tests such as blood gases, electrolytes, metabolites, and coagulation. A variety of cartridges testing different combinations of analytes eliminates the need for different analyzers.
Only a few drops of whole blood—between 65 and 95 µL—are required for testing. Samples are processed immediately and provide lab-quality results quickly.
With clinical guidelines and facility patient care protocols increasing the demand for rapid availability of laboratory testing results, and increased financial pressure and staff shortages, hospital laboratories face unprecedented pressure to perform. The i-Stat system can help meet these demands and maintain compliance with laboratory regulations, all while accelerating the patient care decision-making process.
Features include biosensor technology and advanced microfluidics, automatic calibration, accurate results in 2 minutes, automatic storage of up to 50 results, security features and lockout protocols to assure test result integrity, and connectivity via a state-of-the-art data-management system. The i-Stat’s wide test menu includes blood gases, electrolytes, chemistries, coagulation, cardiac markers (cTnI), and hematology.
Alere Inc: epoc
A cost-effective, point-of-care solution
Distributed by Alere Inc, Waltham, Mass, the epoc from Epocal Inc, Ottawa, Canada, is a point-of-care (POC) blood analysis system that is the first and only wireless bedside testing solution to use smart card technology, which provides state-of-the-art lab results directly to a handheld mobile computer. It requires no refrigeration of consumables and interfaces with a facility’s existing wireless system.
The quality of test results from the epoc system are reportedly equal to or better than the results generated by traditional blood gas or chemistry analyzers run in a laboratory because once fresh blood is passed across biosensors on the epoc test card, results are sent to a mobile computer in just 30 seconds.
Alere promotes epoc as more cost-effective to implement and use than other POC systems, citing the operational costs for the epoc system being at least equal if not less than the cost of testing with conventional analyzers. Unlike other systems, epoc test cards have no refrigerated storage requirements. The cards can be whenever and wherever it’s most convenient for the flow of patient care. A 100-µL blood sample is all that’s required.
Immediate introduction of a patient’s blood sample into an epoc test card minimizes preanalytical sample handling errors. The epoc system features bar code scanning for patient ID, operator ID, and test card information, thereby minimizing data entry and transcription errors.
Readily integrating into your WLAN or mobile EMR solutions—or existing POC testing installations—epoc is expandable. Additional card readers can be placed where needed, and can interact with an unlimited number of epoc mobile computers.
The epoc system also has an evolving test menu and is expected to have numerous panels available in the near future.
The epoc BGEM™ Test Card is a blood gas, electrolyte, and metabolite panel consisting of the following measured analytes: pH, pCO2, pO2, Na+, K+, Ca++, Glu, Lac, and Hct; and calculated values: cTCO2, cHCO3-, BE(ecf), BE(b), cSO2, and cHgb.
Block Scientific: Bayer RapidLab 865
Automatic calibration at intervals you choose
Block Scientific, Bohemia NY, offers the Bayer RapidLab 865 Blood Gas Analyzer, developed by Bayer Healthcare LLC (a part of Siemens Medical Solutions Diagnostics), which is suitable to measure blood gases, metabolites, and electrolytes. Other components, including various hemoglobin derivatives and ionized calcium, can also be measured on this instrument.
Using the Siemens Bayer 865 analyzer, it is possible to obtain calculated parameters such as standard or actual bicarbonate (HCO3), estimated oxygen content (O2 CT), base excess in vivo or in vitro (BEvv or BEvt), base excess of blood [BE(B)] and of extracellular fluid [BE(ecf)], temperature-corrected arterial-alveolar oxygen tension ratio, temperature-corrected pH, pCO2, and O2, temperature-corrected alveolar-arterial oxygen tension difference, temperature-corrected respiratory index, and more.
The Bayer 865 Blood Gas System has fully automated sample delivery, automated sample entry, easy analysis of sample types and devices with small sample size, easy-to-use menu-driven software, and on-screen prompts.
Software is customizable to meet your laboratory requirements. The 865 offers automatic calibration at intervals that you select, QC ranges, patient reference ranges, and printing options that you can customize, flags for results that fall outside expected ranges, and the capacity to store 1,500 patient sample reports.
The system also includes all measured parameters for 1 month’s QC data displayed on the screen, quality control tracking, reduced number of system parts and system complexity, waste system designed for bio-safety, automatic reagent-path cleaning cycle, advanced onboard data management, archive and backup capabilities, and onboard roll printer with paper takeup spool. Sample volume is 125 µL, and throughput is 100 seconds. This is an open system that uses sensor technology. Dimensions are 22 inches (w) x 19 inches (d) x 20 inches (h); and it features three RS232 interfaces, 1 parallel, LED, and a built-in printer.
Instrumentation Labs: Gem Premier 4000
Comprehensive and fast
The Gem Premier 4000 from Instrumentation Labs, Bedford, Mass, is one of the most comprehensive whole blood analyzers available today, offering a flexible analyte menu including pH, pO2, pCO2, electrolytes, metabolites, and onboard CO-oximetry. Easy to use and maintenance-free, the Gem Premier 4000 is ideal for busy labs, and can be used at the point of care and everywhere fast turnaround is mandatory.
Its features include onboard CO-oximetry and a full complement of parameters that meet every testing need; self-contained, multiuse cartridge packs that include all testing components; maintenance-free (cartridges only need replacing every 30 days); iQM, Instrumentation Labs’ proprietary quality management system; and GEMweb Plus, the company’s unique remote management software, enabling access to any networked analyzer to see results, monitor performance, and assure standard configurations.
Nova Biomedical: Stat Profile pHOx
Compact and powerful
By using a unique combination of advanced optical and electrode technology, the Stat Profile pHOx series of analyzers from Nova Biomedical, Waltham, Mass, offer essential blood gas and critical care test menus in the smallest analyzers currently available. The three-test Stat Profile pHOx Basic offers the standard blood gas profile of pH, PCO2, and PO2. The six-test Stat Profile pHOx menu adds measured hematocrit, hemoglobin, and oxygen saturation to provide a complete picture of lung function and oxygen status.
The Stat Profile pHOx Plus adds glucose, sodium, potassium, and a choice of chloride or ionized calcium, resulting in an ideal critical care menu in a small, space-saving instrument. Stat Profile pHOx Plus C offers both chloride and ionized calcium. The Stat Profile pHOx Plus L menu includes lactate.
Though measuring only 12 inches (w) x 12 inches (d) x 15 inches (h), and light enough for easy transport on a compact cart, Stat Profile pHOx analyzers carry enough onboard reagents to perform 7,500 tests and contain a full month’s supply of controls.
A new, liquid-only calibration system eliminates bulky gas tanks, gas regulators, gas tubing lines, and humidifiers. A single reagent pack contains all calibrators. This integrated gas and reagent package system replaces up to five individual reagent bottles and two gas tanks with a simple, snap-in reagent package. The single reagent pack also eliminates the need to maintain logs and run both calibration and QC procedures each time one of the bottles or tanks needs to be replaced.
Radiometer America Inc: ABL90 Flex
Next-generation, cartridge-based, POC analyzer
The winner of a 2010 Medical Design Excellence award and designed specifically for point-of-care (POC) testing, the new ABL90 Flex blood gas analyzer from Radiometer America Inc, Westlake, Ohio, measures 16 parameters in 35 seconds from 65-µL samples, enabling caregivers to spend less time on testing and more time on patient care. The ABL90 Flex also processes up to 44 samples per hour.
Equally well-suited to lab or POC applications, the ABL90 Flex offers automatic quality management and easy replacement of consumables. And with a footprint about the area of a sheet of paper, the ABL90 Flex can fit easily within the confines of the hospital’s clinical POC areas.
In addition to blood gas, the ABL90 Flex measures electrolytes, metabolites, and CO-oximetry; offers automatic sample mixing in just 7 seconds and a sample aspiration in just 5 seconds; and comes with built-in, automatic quality control for accuracy and regulatory compliance.
Radiometer America Inc
Roche Diagnostics: cobas b 221
Enhanced operational efficiency
The cobas b 221 blood gas system from Roche Diagnostics, Indianapolis, a multiparameter analyzer for blood gas, electrolytes, CO-oximetry, and metabolites, provides enhanced operational efficiency with one-touch operation, maximum compliance, and minimum maintenance.
Modularization allows customization of its comprehensive parameter menu as well as analyzer features exactly to your needs.
Measuring 14 x 16 x 18 inches, the system comes in the following six configurations:
- v1-4: offering basic blood gas, directly measured total hemoglobin, and ISEs;
- v5: offering Glucose and Lactate; and
- v6: offering Glucose, Lactate, and BUN/Urea.
From typical sample volumes of 200 µL (BG – ISE – MSS – COOX, or tHB/SO2), 140 µL (BG – ISE – COOX or tHB/SO2), and 100 µL (BG – COOX or tHB/SO2), the cobas b 221 offers throughput of up to 30 samples per hour for syringe and throughput of up to 27 samples per hour for capillary. Analysis times are 115 seconds (tHB/SO2) and 120 seconds (COOX).
The cobas b 221 system offers fast determination of 17 of the most important critical care blood parameters. With the system’s analytical performance, its flexible configuration of parameters, and features supported by its intuitive operation—along with its zero-maintenance sensors—the cobas b 221 system is a valuable and easy-to-use tool for all critical care applications at the point of care, as well as in the laboratory. When equipped with an AutoQC module and connected to Roche’s data and instrument management IT solution, user interaction with the system can be reduced to an absolute minimum.
Siemens Healthcare Diagnostics: RapidLab 1200
Efficiency for today,throughput demand abilities for tomorrow
The RapidLab 1200 system from Siemens Healthcare Diagnostics, Deerfield, Ill, is a blood gas analyzer that can enhance testing efficiency both in the clinical laboratory and at the point of care. Delivering results for all parameters in just 60 seconds, the RapidLab 1200 Analyzer’s speed and accuracy allow clinical staff to make critical decisions quickly, so treatment decisions can be made instantly and patients can get back to their lives faster.
The RapidLab 1200 system maximizes efficiency and throughput by coupling fast turnaround times with a low maintenance, cartridge-based design. Operational flexibility, ease of use, and cost-effectiveness make the RapidLab 1200 Analyzer the perfect choice for medium to high workloads, even at the point of care, with a test menu that includes blood gas (pH, pCO2, and pO2), electrolytes (Na+, K+, Ca++, and Cl-); metabolites (glucose, lactate, and neonatal bilirubin); CO-oximetry (tHb, HHb, O2Hb, sO2, COHb, and MetHb).
Additional features include Ready Sensor technology, a cost-effective cartridge-based system, intuitive touch-screen interface, biosafe, automatic sampling system, and automatic quality control.
Offering short calibration times and an extensive test menu, the RapidLab 1200 seamlessly integrates with Siemens’ RapidComm data-management and connectivity system to ensure that the analyzer’s results reach the right people, at the right location, in real time. RapidComm connectivity resides on the hospital network, streamlining the flow of critical blood gas test information and providing time-sensitive results to clinicians when and where they need them.
Siemens Healthcare Diagnostics
As blood gas analyzers continue to evolve in efficiency, the results they produce will also be more useful—delivered quickly to better reveal clinically valuable information. In turn, diagnoses will be made with greater confidence, leading to appropriate treatments better initiated so that patient care and potential outcomes improve. Simply put, with today’s blood gas analyzers, more questions can be asked, and better answered.
Will Campbell is editor of CLP. He can be reached at .