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Cited by 49Clinical Laboratory Practices and Quality ControlBacterial Identification and Susceptibility TestingSepsis Diagnosis and Treatment

Point of care blood gases with electrolytes and lactates in adult emergencies

Open access
Kapoor, Dheeraj, Srivastava, Meghana, Singh, Pritam·2014·International Journal of Critical Illness and Injury Science
DOI 10.4103/2229-5151.141411PMC PMC4200547
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Abstract

Point-of-care testing (POCT) is one of the formidable concept introduce in the field of critical care settings to deliver decentralized, patient-centric health care to the patients. Rapid provision of blood measurements, particularly blood gases and electrolytes, may translate into improved clinical outcomes. Studies shows that POCT carries advantages of providing reduced therapeutic turnaround time (TTAT), shorter door-to-clinical-decision time, rapid data availability, reduced preanalytic and postanalytic testing errors, self-contained user-friendly instruments, small sample volume requirements, and frequent serial whole-blood testing. However, still there is a noticeable debate that exists among the laboratorians, clinicians, and administrators over concerns regarding analyzer inaccuracy, imprecision and performance (interfering substances), poorly trained non-laboratorians, high cost of tests, operator-dependent quality of testing, and difficulty in integrating test results with hospital information system (HIS). On search of literature using Medline/Pubmed and Embase using the key phrases "ppoint-of-care test," "central laboratory testing," "electrolytes," "blood gas analysis," "lactate," "emergency department," "intensive care unit," we found that POCT of blood gases and selected electrolytes may not entirely replace centralized laboratory testing but may transfigure the clinical practice paradigm of emergency and critical care physicians. We infer that further comprehensive, meaningful and rigorous evaluations are required to determine outcomes which are more quantifiable, closely related to testing events and are associated with effective cost benefits.

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  • Some earlier studies noted positive bias in POCT potassium readings, especially in hemolyzed samples.

    “However, some of these studies also noted positive bias in POCT readings, especially in hemolyzed samples [7,8].”

    From Reliability of Point-of-Care Venous Blood Gas Testing for Potassium and Sodium Compared to Central Laboratory Results in Emergency Patients: A Clinical Audit (2025) · cites this paper as [7]

    The Electrolytes > Sodium, Potassium, Chloride section reports that earlier studies found differences between POCT and central-laboratory potassium readings. It does not report positive bias or identify hemolyzed samples as a particular cause; the specific pediatric ICU study it discusses found underestimation instead. No page number is available in our copy. (LLM, conf=0.79)

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  • Sodium underestimation patterns are supported by studies attributing discrepancies to differences in ion-selective electrode calibration, matrix effects, and ambient temperature and humidity.

    “These patterns are supported by studies such as Kapoor et al. [7] and Allardet-Servent et al. [8], who attribute these discrepancies to differences in ISE calibration, matrix effects, and the influence of ambient temperature and humidity on POCT devices.”

    From Reliability of Point-of-Care Venous Blood Gas Testing for Potassium and Sodium Compared to Central Laboratory Results in Emergency Patients: A Clinical Audit (2025) · cites this paper as Kapoor et al. [7]

    In the Electrolytes—Sodium, Potassium, Chloride section (page unavailable), the review reports sodium underestimation in a pediatric ICU study and says electrolyte discrepancies may reflect device calibrators, sample differences, and direct versus indirect ion-selective electrodes affected by proteins. It does not attribute the discrepancies to ambient temperature or humidity, and it presents the proposed causes cautiously rather than as established explanations. (LLM, conf=0.87)

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Cited by

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Authors
Kapoor, D., Srivastava, M., & Singh, P.
Affiliations
Government Medical College and Hospital (IN)
Corresponding author
Kapoor, Dheeraj
ORCID
Venue
International Journal of Critical Illness and Injury Science
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2014
Volume
4
Issue
3
Pages
216
ISSN
2229-5151 (ISSN-L)
DOI
10.4103/2229-5151.141411
PMC
PMC4200547
OpenAlex
W2020637779
Cited by
49
References
0
Citations by year
2026: 2 · 2025: 7 · 2024: 2 · 2023: 7 · 2022: 6 · 2021: 5 · 2020: 3 · 2019: 7 · 2017: 4 · 2016: 2 · 2015: 4
FWCI
2.22
Type
journal article
Language
en
Open access
Licence
cc-by-nc-sa
Locations
  • International Journal of Critical Illness and Injury Science (publishedVersion)
  • PubMed Central (publishedVersion, cc-by-nc-sa)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
Keywords
point-of-care testing, blood gas analysis, electrolytes, lactate, emergency department, intensive care, centralized laboratory testing, turnaround time, hospital information system integration, cost-benefit analysis

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