Comparison of two portable clinical analyzers to one stationary analyzer for the determination of blood gas partial pressures and blood electrolyte concentrations in horses.
Authors: Kirsch Katharina, Detilleux Johann, Serteyn Didier, Sandersen Charlotte
Journal: PloS one
Summary
# Editorial Summary: Portable Blood Gas Analyzers in Equine Practice Two portable analysers—the VetStat and epoc—were evaluated against a laboratory-standard stationary cobas b 123 analyser using blood samples from 23 hospitalised horses, with results compared using concordance analysis, regression modelling and Bland-Altman limits of agreement. The VetStat demonstrated reliable agreement with the stationary analyser for pH, partial pressure of carbon dioxide (pCO2), bicarbonate and potassium, but showed clinically relevant bias for oxygen partial pressure (pO2: 27.5–33.8 mmHg difference), sodium (4.3–21.6 mmol/L) and chloride (0.3–7.9 mmol/L); the epoc proved acceptable only for bicarbonate and potassium, with significant discrepancies in pH (±0.046), pCO2 (3.6–7.3 mmHg), pO2 (32.7–36.2 mmHg) and sodium (0.3–8.1 mmol/L). For practitioners relying on point-of-care diagnostics in field or ambulatory settings, the VetStat offers a reasonable option for acid-base assessment but requires caution when interpreting electrolyte concentrations and oxygenation status, whilst the epoc's utility is more limited to potassium and bicarbonate determination. These findings underscore the importance of understanding each device's limitations: portable analysers provide valuable rapid feedback for emergency situations, but results for specific parameters may warrant confirmation via laboratory analysis before committing to significant clinical decisions, particularly where electrolyte disturbances or hypoxaemia are suspected.
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Practical Takeaways
- •VetStat portable analyzer is suitable for field assessment of acid-base status (pH, pCO2, HCO3-) and potassium in hospitalized horses, but do not rely on it for oxygen saturation or sodium/chloride values without laboratory confirmation
- •epoc portable analyzer should only be used for quick assessment of HCO3- and K+ in emergencies; all other parameters require confirmation by stationary analyzer before clinical decisions
- •Portable analyzers are useful for rapid triage and monitoring trends in hospitalized cases, but critical decisions regarding electrolyte therapy or oxygenation support should be based on stationary laboratory results
Key Findings
- •VetStat analyzer showed acceptable agreement with cobas b 123 for pH, pCO2, HCO3- and K+, but significant bias for pO2 (27.5-33.8 mmHg difference), Na+ (4.3-21.6 mmol/L difference) and Cl- (0.3-7.9 mmol/L difference)
- •epoc analyzer demonstrated acceptable agreement only for HCO3- and K+, with relevant bias for pH (0.070-0.022 difference), pCO2 (3.6-7.3 mmHg difference), pO2 (36.2-32.7 mmHg difference) and Na+ (0.3-8.1 mmol/L difference)
- •VetStat is more reliable than epoc for equine blood gas analysis in field settings, though caution is warranted for electrolyte and oxygen measurements with both devices