Critical Results for Blood Gases in the NICU
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Good morning,
Does anyone have critical ranges for blood gases and chemistry tests established for a NICU?
The platform that we used is the Abbott I STAT.
Thanks
Does anyone have critical ranges for blood gases and chemistry tests established for a NICU?
The platform that we used is the Abbott I STAT.
Thanks
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| Analyte | Critical Range
| Sodium | <124 or >156 mEq/L
| Potassium | <2.5 or >6.5 mEq/L
| Ionized Calcium | <1.5 mEq/L
| pH | <7.2 or >7.6
| pCO2 | <15 or >70 mmHg
| pO2 (arterial) | <40 mmHg
| HCO3 | <10 or >40 mEq/L
| Glucose | <50 or >300 mg/dL
| Lactate | >45 mg/dL
| Total CO2 | <10 or >40 mEq/L
| Hematocrit | <21 or >65 %
| Hemoglobin | <7 g/dL
| Analyte | Reference Range | Critical Range | Analytical Measurement Range (AMR) | Unit
| pH | 7.350 - 7.450 | <7.20 or >7.60 (art) | 6.500 – 8.000 |
| pCO2 | 35.0 - 45.0 (art)
41.0 - 51.0 (ven) | <20 or >70 (art) | 10 – 160 | mmHg
| pO2 | 83 - 108 | <40 (art) | 5.0 – 620 | mmHg
| Sodium | 135 -145 | <125 or >155 | 80 – 180 | mmol/L
| Potassium | 3.5 - 5.1 | <3.0 or >6.0 | 1.0 – 15.0 | mmol/L
| Chloride | 98 -110 | | 50 – 150 | mmol/L
| iCa | 1.12 – 1.32 | | 0.20 – 2.69 | mmol/L
| HCT | 41 - 53 (male)
36 - 46 (female) | <20.0 or >60.0 | 12% - 70 | %PCV
| HGB | 13.5 - 17.5 (male)
12.0 - 16.0 (female) | <7.0 or >20.0 | 5.0 – 25.0 | g/dL
| Glucose | 65 - 95 | <40 or >500 | 15 – 500 | mg/dL
| Lactate | 0.5 - 1.6 (art)
0.5 - 2.2 (ven) | >3.9 | 0.3 – 20.0 | mmol/L
| Creat | 0.7 - 1.5 | | 0.2 – 12 Epoc
0.2 - 10 Prime | mg/dL
| BUN | 7 - 23 | >90 | 3 – 90 | mg/dL
| iMg | 0.55 - 0.73 | | 0.1 – 1.5 | mmol/L
| SO2% | 95 - 98 (art)
20 - 95 (ven) | | 30 – 100 | %
| MetHb
(Methemoglobin) | 0.0 - 3.0 | >3.0 | 0.3 – 60 | %
| O2Hb
(Oxyhemoglobin) | 94 - 97 | <83.9 | 20 – 100 | %
| COHb
(Carboxyhemoglobin) | 0.0 - 4.0 | >10 | 0.3 – 60 | %
*sorry for mess, the spreadsheet failed to paste into the form.
Yes, we have a few critical ranges specifically for babies - defined as 0-30 days old or NICU. Our NICU babies, especially the micro-premies, will be here longer than 30 days and the neonatologists wanted the ranges to stay newborn-specific.
HBG - <8.5 or >22 g/dL
HCT - >65%
Glucose - <40 or >250 mg/dL
Potassium - <3.0 or >6.9 mmol/L (critical low is same as adult)
Sodium - <126 or > 160 mmol/L (critical high is same as adult)
What did you do to keep istat in your neonatal units after they lost FDA approval for
capillary collections? We switched to EPOC but I am continually getting pushback from staff noting that many hospitals continued with iSTAT.
We have since moved away from iSTAT ABG testing and are now using Epoc and Prime Plus.
Push back that other facilities are doing X thing. My thoughts are this: "I do not care, I really don’t. Are they doing it correctly? Are they in or out of compliance? Perhaps they have the infrastructure that allows them to in the way they are using it but our system setup and patient type doesn’t allow for it. We are going to do it correctly and within regulatory compliance rules of our area for the best patient care here at our facility.”