Manufacturers discuss the state of blood gas analyzers as the technology continues to enable point-of-care diagnostics.
Still the gold standard in measuring blood oxygen levels, arterial blood gas analysis continues to move out of the diagnostics lab and straight to the patient’s bedside. In this industry Q&A, RT speaks with manufacturers on the state of blood gas analyzers, including Nova Biomedical and Werfen.
RT: As technology and sensors have improved over the last 5 years, in general, what features and advantages do today’s blood gas analyzers have over previous generations?
Nova Biomedical: The breadth of the testing menu has increased over the years, expanding to include Creatinine/eGFR, urea, ionized magnesium, estimated plasma volume and mean corpuscular hemoglobin concentration, to name a few. Connectivity/IT solutions have expanded along with the ability for supervisors and managers to remotely access and control analyzers if needed. Today’s blood gas analyzers are easy to operate, require small sample volume, provide test results quickly and accurately. Maintenance of analyzers has been eliminated or is minimal allowing users to focus on patient care.
Werfen: Today’s blood gas analyzer has various advantages over previous generations. Speed has been a huge advantage to blood gas testing—having access to real-time results can be lifesaving for so many patients, whether they’re in the NICU, ED, ICU, or other areas of the hospital.
Before the GEM Premier 7000 with iQM3, hemolysis detection was not possible in point-of-care blood gas testing. Now that we have successfully developed this breakthrough advancement, we can help ensure that patients receive appropriate care. Not only that, but we can tie errors to specific analyzers, areas, or operators, which is important for targeted training programs to prevent future errors from taking place.
RT: What are the most important things RTs should be aware of when collecting ABG samples? What precautions should RTs take to get the best results?
Nova Biomedical: Most important is ensuring the correct identification of the patient and the labelling of the sample. Selecting a site with good blood flow and minimal resistance helps to prevent pre-analytical issues and avoids the need for excessive suction or pressure when obtaining the sample.
Samples should be collected in a balanced heparin syringe designed for blood gas analysis and gently mixed after collection to prevent clots from forming in the sample. Blood gas samples should be analyzed promptly and prior to analyzing the sample, any air bubbles should be displaced or expelled from the sample and the sample should be analyzed as soon as possible.
Werfen: RTs should focus on preanalytical practices, such as proper mixing and sample storage. By doing so, they can help reduce erroneous results associated with the sample. The GEM Premier 7000 system automatically detects sources of error, such as hemolysis and micro-clots, and flags results that have been compromised by such errors. The combination of operators practicing recommended preanalytical sample-handling techniques and a blood gas analyzer that detects common errors contribute to delivering the most accurate results.
RT: Accurate interpretation of arterial blood gas readings is important, so what types of support do your healthcare facilities have in place to ensure accuracy and assist clinicians?
Werfen: Werfen offers Werfen Academy, an online portal, to train RTs on preanalytical sample excellence and proper use of the GEM Premier 7000. Upon installation of the GEM Premier 7000, Werfen’s Applications team ensures successful implementation of the system and trains all users.
The GEM Premier 7000 also identifies which operators have higher sample error rates, highlighting where further training is needed to reduce and even eliminate these errors.
RT: What impact do point-of-care devices have on ABG testing? What advantages do these analyzers offer to respiratory therapists?
Nova Biomedical: Point-of-care devices have brought diagnostic testing directly to the patient providing lab quality results which can be acted on immediately. Analyzers with expanded menus give RTs a more complete and timelier picture of patient status and facilitate better treatment of critically ill patients.
Werfen: Point-of-care blood gas analyzers offer faster results than those obtained in the Lab. Rather than spending critical time waiting for results, clinicians can obtain results in minutes and take prompt action.
Speed comes into play with hemolysis detection at the point of care, too. Previously, if hemolysis was suspected in blood gas testing, the sample was sent to the lab for additional testing. Now, the GEM Premier 7000 flags a hemolyzed sample 45 seconds, or provides assurance that hemolysis is not present, informing rapid patient management decisions.
RT: What changes do you anticipate, or what changes would you like to see, in blood gas analysis technology in the next 5 years?
Nova Biomedical: We will continue to see increased testing menus on blood gas/critical care analyzers. IT/connectivity solutions will continue to compliment analyzers and the ability to perform more activities on analyzers from remote locations will be some of the advancements that will likely be seen.
Werfen: Over the next five years, we aim to make hemolysis detection at the point of care the standard of care in blood gas testing. This “new norm” will help clinicians provide the best patient care.
RT
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