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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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Purpose: Current methods to evaluate the blood concentration of potassium (K) on point-of-care (POC) are influenced by the relative volumes of heparin and arterial blood. Blood potassium concentration may be underestimated with a high volume of heparin or low volume of blood. This dilution effect can produce false negative results that negatively affect decision-making of clinicians and throw critical patients into crisis. We hypothesized that the application of a dried balanced heparin syringe in rapid POC-K+ could attenuate the dilution effect and would more accurately and consistently measure the concentration of potassium compared with reference testing in emergency situations. Methods: This retrospective study was conducted between January, 1, 2008 and September, 30, 2013 at an urban hospital affiliated with our institution. To attenuate the dilution effect, dried balanced heparin syringes (HS) were also used between October, 1, 2011 and September, 30, 2013. Concentrations of potassium were compared between the dried balanced HS group and the liquid HS group. The reliability of each of these outcome measures was assessed using intra-class correlation coefficient analysis. Results: Application of dried balanced HS improved the degree of concordance for potassium using two different assays. The false negative rate was significantly improved from 9.1% (95% CI 7.3-11.0) to 5.7% (95% CI 3.5-8.0) in the dried balanced HS group compared with the liquid HS liquid group (p=0.037). Conclusion: This study suggests that the usage of dried balanced HS could attenuate the dilution effect in rapid POC-K+ and predict potassium levels more accurately for identification of patients at risk of hyperkalemia in emergency situations.
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참고문헌 (13)
참고문헌 신청
Lehnhardt A / 2011 / Pathogenesis, diagnosis and management of hyperkalemia / Pediatr Nephrol 26:377~384
Hsieh MF / 2011 / Higher serum potassium level associated with late stage chronic kidney disease / Chang Gung Med J 34:418~425
An JN / 2012 / Severe hyperkalemia requiring hospitalization: predictors of mortality / Crit Care 16:R255
Tintinalli JE / 2011 / Emergency Medicine: A comprehensive study guide / The McGraw-Hill :173
유제성 / 2014 / Evaluating the Utility of Rapid Point-of-Care Potassium Testing for the Early Identification of Hyperkalemia in Patients with Chronic Kidney Disease in the Emergency Department / Yonsei Medical Journal 55(5):1348~1353
Hsieh MF / 2011 / Higher serum potassium level associated with late stage chronic kidney disease / Chang Gung Med J 34:418~425
An JN / 2012 / Severe hyperkalemia requiring hospitalization: predictors of mortality / Crit Care 16:R255
Tintinalli JE / 2011 / Emergency Medicine: A comprehensive study guide / The McGraw-Hill :173
유제성 / 2014 / Evaluating the Utility of Rapid Point-of-Care Potassium Testing for the Early Identification of Hyperkalemia in Patients with Chronic Kidney Disease in the Emergency Department / Yonsei Medical Journal 55(5):1348~1353
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