Neonatal Medicine

The Korean Society of Neonatology (대한신생아학회)
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Clinical Usefulness of Point-of-care Test Chemistry Analyzer in Neonatal Intensive Care Unit

  • Jang, Yeong-Uk (Department of Pediatrics, Graduate School of Medicine, Gachon University of Medicine and Science) ;
  • Kim, Su-Nam (Department of Pediatrics, Graduate School of Medicine, Gachon University of Medicine and Science) ;
  • Cho, Hye-Jung (Department of Pediatrics, Graduate School of Medicine, Gachon University of Medicine and Science) ;
  • Sun, Yong-Han (Department of Pediatrics, Graduate School of Medicine, Gachon University of Medicine and Science) ;
  • Shim, So-Yeon (Department of Pediatrics, Graduate School of Medicine, Gachon University of Medicine and Science) ;
  • Son, Dong-Woo (Department of Pediatrics, Graduate School of Medicine, Gachon University of Medicine and Science) ;
  • Park, Pil-Whan (Department of Laboratory Medicine, Graduate School of Medicine, Gachon University of Medicine and Science)
  • Published : 2011.11.30
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Abstract

Purpose: Point-of-care tests (POCTs) have the potential to significantly influence management of neonates. The aim of this study was to assess the clinical usefulness of the POCT chemistry analyzer in a neonatal intensive care unit (NICU). Methods: Blood samples of neonates admitted to the NICU were tested using a POCT chemistry analyzer (Piccolo Xpress Chemistry Analyzer, Abaxis, Union City, CA, USA) and a central laboratory chemical analyzer (Chemistry analyzer 7600-110, Hitachi Ltd., Tokyo, Japan) from March to September, 2010. Correlation of 15 analytes between the POCT and the central laboratory machine was evaluated. For consistency of the POCT, three consecutive samplings were performed. Differences among the three tests were recorded. The causes of performance errors were checked through log files. Results: One hundred of 112 pairs of tests for accuracy performed in 54 neonates showed a high correlation between the two machines. Twelve performance errors occurred during the 112 tests. The most common error was insufficient sample error. Eighteen triplet tests performed in 18 patients for consistency revealed a difference range of 3-10%, which was considered to be acceptable. No error occurred during the 54 tests. Conclusion: The POCT is capable of analyzing multiple analytes with a minimal amount of whole blood in a short time. The few performance errors noted presently are likely preventable. This POCT is concluded to be suitable for use as a simple and rapid diagnostic method in the NICU with a minimal amount of blood collected in a less invasive manner.

목적: Point-of-care test (POCT) 는 신생아 치료에 있어서 중요한 영향을 미칠 잠재력을 가지고 있다. 이 연구의 목적은 신생아 집중 치료실에서 POCT 화학 분석기기의 임상적인 유용성을 살펴보고자 하는데 있다. 방법: 신생아 집중 치료실에 입원한 신생아의 혈액 샘플을 2010년 3월부터 9월까지 POCT 화학 분석기기(Piccolo Xpress Chemistry Analyzer, Abaxis, Union City, CA, USA) 와 중앙 검사실 화학 분석기기(Chemistry analyzer 7600-110, Hitachi Ltd., Tokyo, Japan)를 이용하여 분석하였다. POCT와 중앙 검사실 기계 간의 15가지 항목에 대하여 상관 관계를 평가하였다. 또 POCT의 일치도를 알아보기 위해 세 번의 연속적인 혈액 검사를 시행하고, 세 검사간의 차이를 기록하여 평가하였다. 수행 오류가 있는 경우에는 log file을 통해서 오류의 원인을 파악하였다. 결과: 54명의 신생아에서 정확도를 위해 시행된 112쌍의 연구 중 오류가 없던 100쌍의 결과에서 두 기계 간의 높은 상관 관계를 보였다. 112쌍의 연구 도중 12개의 오류가 발생하였다. 가장 흔한 원인은 불충분한 샘플 오류였다. 일치도 검증을 위한 18명의 환아들에서 시행한 18개의 삼중 분석에서는 3-10%의 오차율이 나타났고, 이는 수용할 만한 것이었다. 54개의 분석 중 오류는 일어나지 않았다. 결론: 이 POCT는 짧은 시간 내에 소량의 전혈을 이용하여 다양한 항목을 검사할 수 있다. 비록 오류가 나타날 수 있지만, 이는 예방 가능한 것으로 사료된다. 이 POCT는 덜 침습적인 방법으로 소량의 혈액을 채취하기 때문에 신생아 집중 치료실에서 간단하고 빠른 진단에 유용하다.

Keywords

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