Lab Med Online.  2023 Oct;13(4):308-317. 10.47429/lmo.2023.13.4.308.

Evaluation of Two Safety Syringes for Arterial Blood Gas Analysis

• Kim A
• Lee S
• Kim S
• Lee W
• Chun S
• Min WK

• KMID: 2552757
• DOI: http://doi.org/10.47429/lmo.2023.13.4.308

Abstract

Background
Arterial blood gas (ABG) analysis is a crucial test providing vital information for patients who are critically ill. Accurate results are essential; however, pre-implementation evaluation of ABG syringes is uncommon. We evaluated the performance of the Greenmedi heparin syringe (GRS; SANG-A FRONTEC, Korea) and the Portex arterial blood sampling kit (POS; Smiths Medical, USA), which are widely used in clinical laboratories.
Methods
Samples from Asan Medical Center were assessed for clotting rate and hemolysis rate. Gas permeability, sample volume impact, precision, and concordance were evaluated using quality control materials. Gas permeability was assessed by measuring pO 2, pCO 2, and pH after storing the materials for different time periods. The influence of sample volume was tested at various quantities. Precision was evaluated through repeated tests, and concordance between the two syringes’ results was analyzed.
Results
GRS had a clotting rate of 1.07% (51/4,769), exceeding the acceptable range, whereas POS had no clotted samples (0/387). Hemolysis rates were 14.9% (14/94) for GRS and 10.0% (8/80) for POS, both higher than the acceptable rate. Both syringes had a storage time of less than 10 minutes and required a minimum sample volume above 0.6 mL. Precision was noteworthy, but there was a relatively weak concordance between pO 2 values obtained with the two syringes.
Conclusions
Both syringes demonstrated notable precision but had high hemolysis rates. Results showed low concordance and were influenced by storage time and sample volume. Caution should be exercised when using these syringes, and it is recommended to assess their quality before implementation in each laboratory.

Keyword

Blood gas analysis; Syringes; Evaluation

Figure

• 

  Fig. 1 Study flow diagram for arterial blood gas analysis of GRS and POS samples. (A) Clotting rate and (B) hemolysis rate. Abbreviations: GRS, Greenmedi heparin syringe; POS, Portex arterial blood sampling kit; ABGA, arterial blood gas analysis; ICU, intensive care unit; pHb, plasma hemoglobin.

• 

  Fig. 2 Passing–Bablok regression and Bland-Altman analysis of 120 QC materials. The pO2, pCO2, and pH results obtained using the Portex arterial blood sampling kit (POS) compared with those obtained using the Greenmedi heparin syringe (GRS) were plotted with the passing-Bablok regression and identity lines (left). The equations of the regression lines are shown (left) and the Bland-Altman plots are displayed on the right side. Abbreviations: pO2, partial pressure of oxygen; pCO2, partial pressure of carbon dioxide.

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