"Recipes" for instrument correlations
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Does anyone have any tries and true "recipes" they can share for doctoring blood samples to get a better range of results for Sodium, Glucose, Potassium, iCA?
Thanks so much!
jennifer.detiveaux@lcmchealth.org
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Hi,
I only have a procedure for glucose. It is the “spiking” procedure from Roche that I use for our glucometers.
Kathy Andrews
MLT, RT
Point of Care Coordinator / Coordinatrice des Analyses Hors Laboratoire
Moncton & Miramichi Area /
Régions de Moncton et Miramichi
Horizon Health Network / Reseau de Sante Horizon
Tel: (506)-857-5315 Fax: (506) 857-5325
kathy.andrews@horizonnb.ca
“Be the change that you wish to see in the world.”
― Mahatma
Gandhi
From: Jennifer Detiveaux via POCT Listserv (Groupsite) <users+1251769@poct.groupsite.com>
Sent: August 20, 2020 10:51 AM
To: Andrews, Kathy (LAB) (HorizonNB) <Kathy.Andrews@HorizonNB.ca>
Subject: [POCT Listserv] "Recipes" for instrument correlations
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For a low result for glucose I just let one whole blood sample sit on a bench overnight and then the result is in the low range due to glycolysis.
Kathy Andrews
MLT, RT
Point of Care Coordinator / Coordinatrice des Analyses Hors Laboratoire
Moncton & Miramichi Area /
Régions de Moncton et Miramichi
Horizon Health Network / Reseau de Sante Horizon
Tel: (506)-857-5315 Fax: (506) 857-5325
kathy.andrews@horizonnb.ca
“Be the change that you wish to see in the world.”
― Mahatma
Gandhi
From: Jennifer Detiveaux via POCT Listserv (Groupsite) <users+1251769@poct.groupsite.com>
Sent: August 20, 2020 10:51 AM
To: Andrews, Kathy (LAB) (HorizonNB) <Kathy.Andrews@HorizonNB.ca>
Subject: [POCT Listserv] "Recipes" for instrument correlations
ATTENTION! External email / courriel externe.
------- Horizon Health Network Disclaimer -------
This e-mail communication (including any or all attachments) is intended
only for the use of the person or entity to which it is addressed and may
contain confidential and/or privileged material. If you are not the intended
recipient of this e-mail, any use, review, retransmission, distribution,
dissemination, copying, printing, or other use of, or taking of any action in
reliance upon this e-mail, is strictly prohibited. If you have received this
e-mail in error, please contact the sender and delete the original and any
copy of this e-mail and any printout thereof, immediately. Your
co-operation is appreciated.
Le présent courriel (y compris toute pièce jointe) s'adresse uniquement à
son destinataire, qu'il soit une personne ou un organisme, et pourrait
comporter des renseignements privilégiés ou confidentiels. Si vous n'êtes
pas le destinataire du courriel, il est interdit d'utiliser, de revoir, de
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reconnaissants de votre collaboration.
Bear in mind it takes practice and time to get the exact values you need, I use these formulas for validations to broaden our ranges. Depending upon the analyzer you're using these manipulations may not work. For example our EPOCs do not like these manipulated samples. Best of luck!
Glucose: old samples, usually 30-48 hours old will give a glucose of less than 20 ( I need values of 6-10 mg/dL). For high samples I use glucola juice ( literally a tiny drop out of a plastic pipette will add 200+ mg/dL to your value. Be sure to mix well.
Sodium: 1 Molar NaCl solution 5.84 of (SODIUM CHLORIDE crystal I borrow from our Toxicology department) into 100mL diH20. This will give you both high of sodium and chloride. Dilute down to what you need or add to blood to keep sample within matrix.
Potassium: for high K+ samples mix blood in an EDTA tube. For low potassium dilute out anemic patient sample with saline
iCA: low dilute with saline or use old sample (48 hours or more old). For high sample add 1-2 drops of 2M CaCl2 solution (we use this for our TEG machines)
For low glucose, we let the tube sit out overnight and let glycolysis do its thing. For high glucose, we spike with 5% dextrose solution - you just need a very tiny amount so it doesn't compromise the sample matrix.
For sodium, potassium and iCa we spike the whole blood samples with our linearity materials. We were also able to spike with pH buffer to move the needle for pH samples across the range we needed, but that will throw all of your other analyte measurements out of whack if you are testing multiple at once, just FYI.
Hope this helps! Erin
I never had to doctor specimens - what is this for?
Thank y'all so much! I love playing made scientist!
Joan - when I perform correlations between my iSTATs and GEM, I find it difficult to doctor samples that give me a broader range of results. The hard part is not adding too much or too little or changing the matrix so that I get a reading on both.