EVALUATION OF I-STAT PORTABLE CLINICAL ANALYZER IN A HEMODIALYSIS UNIT

Objective: To evaluate a hand held portable i-STAT analyzer used for p oint-of-care testing in a hemodialysis unit. Design and Methods: Impre cision and comparison studies. Assays by nonlaboratory personnel. Resu lts: Study of both quality control solutions and hemodialysis patients ' duplicate blood specimens with 6+, E3+, EC6+, and EC8+ cartridges bo th gave CVs for sodium, potassium, chloride, pH, and ionized calcium o f 0 to 2.2%. CVs for hematocrit, glucose and pCO(2) for whole blood du plicates were 4.6, 3.5, and 4.0%. The mean differences between i-STAT and central laboratory values for the above compounds and urea, when e xpressed as a % of mean central laboratory values were 0.2 and 3.1%, e xcept for an ionized calcium value of 4.3% (for which there is an expl anation) and for glucose (11%) that were both higher for i-STAT. Preli minary data suggest that sodium, potassium, ionized calcium, and pH ca n be assayed in the aqueous dialysate fluid used for hemodialysis. Con clusions: We confirm previous reports that i-STAT cartridges give simp le, rapid, and reliable values for sodium, potassium, chloride, urea, glucose, and hematocrit that are clinically acceptable when performed by nonlaboratorians, but also suggest the same conclusions apply to io nized calcium, pH, and pco(2). The hemodialysis unit may prove to be o ne of several hospital units where the analyzer has considerable value .