Cho J, Kim YS, Kim YH, Lee JY, Bae IC, Lee SG, Kim JH. Comparison of analytical performance of i-Smart 300 and pHOx ultra for the accurate determination of pleural fluid pH.
Pract Lab Med 2019;
14:e00117. [PMID:
30815526 PMCID:
PMC6378778 DOI:
10.1016/j.plabm.2019.e00117]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 01/09/2019] [Accepted: 01/25/2019] [Indexed: 11/30/2022] Open
Abstract
Background
Pleural fluid pH is an essential test for diagnosing complicated parapneumonic effusion. We evaluated the performance of two blood gas analyzers in measuring pleural fluid pH.
Methods
The i-STAT G3+ (Abbott) was used as a reference analyzer to evaluate the pH values obtained from other methods: the i-Smart 300 (i-SENS), the pHOx Ultra (Nova Biomedical), using a clot catcher to filter off microclot, and pH indicator paper. Within-device precision was performed using quality control materials. We compared pleural fluid pH (n = 86) by the above methods and analyzed the concordance rate at the level of the medical decision point, pH 7.2.
Results
The within-device coefficient of variations of pH were below 0.1% for all blood gas analyzers tested. The slopes of the regression equations for the i-Smart 300, pHOx Ultra, and pH indicator paper against the reference analyzer were 0.850 (95% confidence interval, CI, 0.800–0.896), 0.714 (95% CI, 0.671–0.766), and 1.105 (95% CI, 0.781–1.581), respectively. The kappa values for the i-Smart 300, pHOx Ultra, and pH indicator paper against the reference analyzer were 0.883 (95% CI, 0.656–1.110), 0.739 (95% CI, 0.393–1.084), and 0.464 (95% CI, 0.102–0.826), respectively.
Conclusions
The i-Smart 300 and pHOx Ultra demonstrated good analytical performance and diagnostic accuracy when determining pleural fluid pH compared with that by the i-STAT G3+, whereas the pH indicator paper showed unsatisfactory results.
Pleural fluid pH should be determined by a blood gas analyzer using anaerobically collected blood in a heparinized syringe.
Both i-Smart 300 and pHOx Ultra blood gas analyzers showed acceptable performance for the determination of pleural fluid pH.
Use of a Clot Catcher prevented instrument errors when testing pleural fluid pH on both blood gas analyzers.
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