The incidence of electrolyte and acid-base abnormalities in critically ill patients using point of care testing (i–Stat portable analyser)

Abstract

Background: Electrolytes and acid-base disorders are common challenges seen in the intensive care unit (ICU) resulting in difficulty in weaning patients off the ventilator, prolonged admission periods, preventable cardiac arrhythmias and cardiac arrest. These require prompt lab results most of which are done serially, ideally a point of care test (POCT), as most central hospital lab result's turnaround time (TAT) sometimes might not meet up with the urgency of clinical decision making in the ICU.
Objective: To determine the incidence of electrolytes and acid-base abnormalities using i-Stat portable analysers in the ICU of the Lagos University Teaching Hospital (LUTH).
Method: The i-STAT Portable Clinical Analyzer, a POCT system consisting of a hand-held analyzer and single-use cartridges that measure different panels of analytes in 65–100 μl of blood using an EC8+ cartridge type analyzer for sodium, potassium, chloride, urea, glucose, pH, blood gases [TCO₂, pO₂, pCO₂]) and heamatocrit was used.
Results: Over 66.78% of the patients had multiple electrolytes and acid-base abnormalities. Azotemia in 20%, hypoglycaemia in 13.33%, and hyperglycaemia in 53.33% of patients.
Conclusion: it is concluded from this study that electrolyte and acid base abnormalities is not uncommon in the intensive care unit of LUTH and the i-STAT Portable Clinical Analyzer was helpful in facilitating early diagnosis and treatment.

Key words: Electrolytes, acidosis, alkalosis, Critically-illpatients