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"Dueling Algorithms": Evaluating Two Computerized Tools for Temperature Adjustment of Arterial Blood Gas (ABG) Parameters During Therapeutic Hypothermia FREE TO VIEW

Brian Gardner, RRT; Robert Demers; Sokcheat Ly-Stewart; Jonathan Rogel
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Southern California Permanente Medical Group, Kaiser Permanente Downey Medical Center, Downey, CA

Chest. 2014;146(4_MeetingAbstracts):571A. doi:10.1378/chest.1988806
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SESSION TITLE: Diagnostic Procedures and Interventions Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Some arterial blood gas (ABG) analyzers incorporate algorithms which enable these devices to determine certain ABG parameters at hypothermic temperatures. A stand-alone spreadsheet has previously been described1. It implements temperature adjustments whenever in vivo temperatures vary substantially from 37°, such as occurs during therapeutic hypothermia. We compared the performance of an integral software package (Radiometer Medical ApS, Westlake, OH) to that of the spreadsheet.

METHODS: We employed ampules of a pre-packaged control solution (Radiometer QUALICHECK5+®, Level 2, QC number 944-018), aspirating serial aliquots into an analyzer (Radiometer ABL820) for temperatures of 37°, 35°, 34°, 33°, 30°, 25°, and 20° C. The digital values generated by the on-board algorithm were then compared to the corresponding readouts from the spreadsheet.

RESULTS: The data generated by the analyzer’s algorithm were in fairly good agreement with the parameters furnished by the spreadsheet. The numerical differences between the ABL’s pHa and the spreadsheet’s pHa ranged between -0.001 and +0.004 units, while the numerical differences for paCO2 between the two methods ranged between -1.8 torr and -0.1 torr.

CONCLUSIONS: The spreadsheet was previously observed to generate values identical to those published in a classic text (Shapiro BA, Harrison RA, Walton JR. Clinical Application of Blood Gases, 3rd Edition, Chicago, IL, Year Book Medical Publishers, 1977, Table 49.1).

CLINICAL IMPLICATIONS: The ABL’s algorithm supplied pHa and paCO2 figures which appear to be suitably accurate within the range of temperatures typically observed during therapeutic hypothermia.

DISCLOSURE: The following authors have nothing to disclose: Brian Gardner, Robert Demers, Sokcheat Ly-Stewart, Jonathan Rogel

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