A two-center evaluation of the blood gas Immediate Response Mobile Analyzer (IRMA)
Pierangelo Bonini, Ferruccio Ceriotti, Laura DEL BUONO, Carlo A. FERRERO, Luca Germagnoli, Alessandro Marocchi and Mario PEZZO
The Immediate Response Mobile Analyzer (IRMA) is a selective and portable point-of-care testing (POCT) blood gas, electrolyte and hematocrit (Hct) analyzer. The overall analytical performance was evaluated in a two-center study involving two Italian hospital laboratories, following the guidelines suggested by the manufacturer (based on the NCCLS protocol), after a preliminary evaluation of their formal validity. The IRMA was compared to the analyzers used in the routine laboratory as reference. The considered parameters were pH, pO2, pCO2, Na+, K+, ionized calcium and Hct. When using the aqueous quality control material provided by the manufacturer most of the parameters showed good precision, with the exception of pCO2 and pO2 that showed high CVs on two of the three levels of the aqueous control. We could demonstrate that this imprecision was material-related and was reduced when using a different material (blood equilibrated by tonometry). With tonometred blood for pO2 and pCO2 and the aqueous material for the remaining parameters the CVs were all below 5%, ranging from 0.08% to 2.8%. The IRMA results correlated adequately with the comparison instruments, with the exception of sodium and ionized calcium where contradictory results were obtained in the two centers.
Clinical biology ; Point of care testing ; Human ; Laboratory investigations ; Technique ; Performance evaluation ; Portable equipment ; Point of care testing ; Calcium ; Electrolyte ; Hematocrite ; Blood gas ;
Ultrasonographic monitoring and early diagnosis of stroke
Scientific Research, Medicine, Health, Life Sciences
Laboratoire Ondes et Acoustique
Groupement D'interêt Public "ultrasons"
Institut National de la Sante et de la Recherche Medicale
Bracco Research SA
Neurologische Klinik Der Ruhr - Universitaet Bochum
University of Leicester
University of Florence
University of Luebeck
RUPRECHT-KARLS-UNIVERSITAET HEIDELBERG DEUTSCHLAND
GROUPEMENT D'INTERÊT PUBLIC "ULTRASONS" FRANCE
INSTITUT NATIONAL DE LA SANTE ET DE LA RECHERCHE MEDICALE FRANCE
BRACCO RESEARCH SA SCHWEIZ/SUISSE/SVIZZERA
NEUROLOGISCHE KLINIK DER RUHR - UNIVERSITAET BOCHUM DEUTSCHLAND
UNIVERSITY OF LEICESTER UNITED KINGDOM
UNIVERSITY OF FLORENCE ITALIA
UNIVERSITY OF LUEBECK DEUTSCHLAND
The UMEDS project will establish non-invasive techniques for early diagnosis and bedside monitoring of stroke to improve stroke outcome. An important goal will be to expand recent developments in microbubble technology and ultrasonographic harmonic imaging to establish ultrasound techniques for both qualitative and quantitative evaluation of brain perfusion. UMEDS will develop new technologies to meet these goals. These include an automated system for detection of microemboli, a device for imaging the brain through the skull, a dual transducer system for microemboli detection and enhanced features for commercial applications of ultrasound perfuson imaging. We will investigate novel targeted microbubble technology for characterizing microemboli.
Altered Cardiac Repolarization in Association with Air Pollution and Air Temperature among Myocardial Infarction Survivors
Susanne Breitner, Irene Brüske, Josef CYRYS, Regina Hampel, Harald KORB, Annette Peters, Regina Rückerl, Alexandra E. SCHNEIDER, Jordi Sunyer, H.-Erich WICHMANN and Wojciech Zareba
BACKGROUND: Epidemiological studies have shown that ambient particulate matter (PM) and changes in air temperature are associated with increased cardiopulmonary events. OBJECTIVE: We hypothesized that patients with previous myocardial infarction (MI) experience changes in heart rate (HR) and repolarization parameters, such as Bazett-corrected QT interval (QTc), and T-wave amplitude (Tamp), in association with increases in air pollution and temperature changes. METHODS: Between May 2003 and February 2004, 67 MI survivors from the Augsburg KORA-MI registry repeatedly sent 16 sec electrocardiograms (ECGs) with a personal transmitter (Viapac) via telephone to the Philips Monitoring Center, where ECG parameters were immediately analyzed. Meteorological data and air pollutants were acquired from fixed monitoring sites on an hourly basis. Additive mixed models were used for analysis. Effect modification by patient characteristics was investigated. RESULTS: The analysis of the 1,745 ECGs revealed an increased HR associated with interquartile range (IQR) increases in PM levels among participants not using beta-adrenergic receptor blockers and among those with body mass index ≥ 30 kg/m2. We observed a 24- to 47-hr lagged QTc prolongation [0.5% change (95% confidence interval, 0.0-1.0%)] in association with IQR increases in levels of PM ≤ 2.5 μm in aerodynamic diameter, especially in patients with one [0.6% (0.1-1.0%)] or two [1.2% (0.4-2.1%)] minor alleles of the nuclear factor (erythroid-derived 2)-like 2 (NFE2L2) single-nucleotide polymorphism rs2364725. Positive immediate (0-23 hr) and inverse delayed (48-71 hr up to 96-119 hr) associations were evident between PM and Tamp. We detected an inverse U-shaped association between temperature and Tamp, with a maximum Tamp at 5°C. CONCLUSIONS: Increased air pollution levels and temperature changes may lead to changes in HR and repolarization parameters that may be precursors of cardiac problems.
Myocardial disease ; Coronary heart disease ; Cardiovascular disease ; Epidemiology ; Survivor ; Temperature ; Myocardial infarction ; Public health ; Health and environment ; Air pollution ; Human ; Heart ; Toxicity ; air pollution ; air temperature ; epidemiology ; myocardial infarction ; panel study ; repolarization ;