1.Hyperkalemia measurement between Blood Gas Analyser and Main Laboratory Biochemistry Analyser
Mohd Helmie Ismail ; Kamarul Aryffin Baharuddin ; Mohd Azmi Suliman ; Mohd Faiz Mohd Shukri ; Siti Natrah Che Has ; Zhen Zhen Lo
The Medical Journal of Malaysia 2021;76(2):157-163
Introduction: Potassium level is measured for patients with
high risk of hyperkalemia in the emergency department (ED)
using both blood gas analyser (BGA) and biochemistry
analyser (BCA). The study was conducted to evaluate the
correlation and agreement of potassium measurement
between BGA and BCA.
Materials and Methods: This is a prospective cross-sectional
study on the data obtained from Hospital Universiti Sains
Malaysia (Hospital USM) from Jun 2018 until May 2019. Blood
samples were taken via a single prick from venous blood and
sent separately using 1ml heparinised syringe and were
analysed immediately in ED using BGA (Radiometer, ABL800
FLEX, Denmark) and another sample was sent to the central
laboratory of Hospital USM and analysed by BCA (Architect,
C8000, USA). Only patients who had potassium levels
≥5.0mmol/L on blood gas results were included. A total of 173
sample pairs were included. The correlation and agreement
were evaluated using Passing and Bablok regression, Linear
Regression and Bland-Altman test.
Result: Of the 173 sample pairs, the median of potassium
level based on BGA and BCA were 5.50mmol/L (IQR: 1.00)
and 5.90mmol/L (IQR: 0.95) respectively. There was
significant correlation between two measurements (p<0.001,
r: 0.36). The agreement between the two measurements
showed within acceptable mean difference which was 0.27
mmol/L with 95% limit of agreement were 1.21mmol/L to
1.73mmol/L.
Conclusion: The result of blood gas can be used as a guide
for initial treatment of hyperkalaemia in critical cases where
time is of the essence. However, BCA result is still the
definitive value.