Effects of pre-analytical sample care and analysis methodology on measures of metabolic acidosis in hemodialysis patients

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2023-02-14 DOI:10.1111/hdi.13069

Camilla C. Correa, Mariana M. B. Figueiredo, Analucia R. Xavier, Salim Kanaan, Jocemir R. Lugon

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Abstract

Introduction

We evaluated the effects of pre-analytical care on total carbon dioxide (tCO₂) in hemodialysis patients, as calculated by blood gas analysis (ctCO₂) or measured by an enzymatic assay (mtCO₂).

Methods

Blood samples were collected via vascular access before dialysis sessions. For blood gas analysis, eight aliquots were collected, refrigerated or non-refrigerated, and analyzed at 0, 4, 8, and 24 h after collection. A blood sample was then collected for the enzymatic method and distributed into 14 aliquots. Half of the aliquots were refrigerated. The samples analyzed at time point 0 were centrifuged immediately. The remaining aliquots of both the refrigerated and non-refrigerated clusters were centrifuged before storage. Samples were analyzed at 4, 8, and 24 h post-collection.

Findings

By blood gas analysis, no significant change was found in bicarbonate values over time, either in the non-refrigerated or refrigerated samples. ctCO₂ values during the experiment showed a minor but statistically significant increase of questionable clinical relevance in both non-refrigerated and refrigerated aliquots. In the enzymatic assay, the reduction in mtCO₂ levels during the experiment was negligible. The median absolute reductions at the end of the experiment were 1.77, 1.21, 1.04, and 1.12 mmol/L for the non-centrifuged/non-refrigerated, centrifuged/non-refrigerated, non-centrifuged/refrigerated, and centrifuged/refrigerated aliquots, respectively.

Discussion

Our results suggest that measured or calculated tCO₂ levels of capped and cooled samples are adequate for analyzing the acid–base status of hemodialysis patients, even when such determination is not performed immediately after collection.

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分析前样品护理和分析方法对血液透析患者代谢性酸中毒测量的影响

我们评估了分析前护理对血液透析患者总二氧化碳(tCO2)的影响，通过血气分析(ctCO2)计算或酶分析(mtCO2)测量。方法透析前经血管通道采血。血气分析，收集8个等分，冷藏或不冷藏，并在收集后0、4、8和24小时进行分析。然后收集血液样本用于酶法，并将其分成14份。一半的等分水被冷藏。在时间点0分析的样品立即离心。冷冻和非冷冻的剩余等分在储存前进行离心。在采集后4、8和24 h对样品进行分析。通过血气分析，无论是在非冷藏还是冷藏样品中，碳酸氢盐值都没有随着时间的推移而发生显著变化。实验期间的ctCO2值显示，在非冷藏和冷藏等分中，可疑的临床相关性有轻微但统计学上显著的增加。在酶促分析中，实验期间mtCO2水平的降低可以忽略不计。实验结束时，非离心/非冷藏、离心/非冷藏、非离心/冷藏、离心/冷藏和离心/冷藏等分的绝对降低中值分别为1.77、1.21、1.04和1.12 mmol/L。我们的研究结果表明，封顶和冷却样品的测量或计算的tCO2水平足以分析血液透析患者的酸碱状态，即使在收集后没有立即进行这种测定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.