The Science Journal of the American Association for Respiratory Care

1999 OPEN FORUM Abstracts

EVALUATION OF THE VIA LVM EX-VIVO BLOOD GAS AND CHEMISTRY MONITOR.

Richard Lawhead, BS, RRT, CPFT, P/P Spec., Patty Munro, RRT, Mark Heullit, MD, Arkansas Children's Hospital

Background: The VIA LVM is a bedside, in-line, ex-vivo monitor designed to provide real-time results for blood gases, electrolytes, and hematocrit. A specialized VIA stopcock allows the system to be used concurrently with existing arterial or central venous lines. On demand, 1.5mLs of blood are gently drawn from the patient into the sensor with measured values for pH, pCO2, pO2, Na+, K+, and Hct being obtained in 70 seconds. All but 0.02mL of blood is returned to the patient with a 0.5mL flush.

Methods: Patients in our NICU, CVICU, and PICU who had either an arterial or central venous line in place were selected. When an ABG/VBG was scheduled, a paired-sample analysis was performed. As the VIA LVM was in the process of analyzing blood drawn from the patient, the VIA stopcock was manually turned off to the sensor and blood was drawn for routine analysis and immediately sent to the STAT Lab for processing (Chiron 865). Draw times and run times were recorded for each sample. Questionnaires were also provided to receive subjective evaluation from the staff.

Results: 115 paired samples were obtained from 12 patients over a five-day period. Age range was from 26 weeks gestation to 1 year old. Weight range was from 620 grams to 9.6 kg. No complications linked to the VIA were noted.

pH pCO2 pO2 pO2(%) Na+ K+ Hct
Bias 0.01 -1.2 3.4 2% 2.7 -0.1 1.7
Precision 0.02 3.2 9.9 10% 2.3 0.2 2.6
Min 7.24 23.5 20.8 20.8 130 2.5 30
Max 7.58 63.1 230.6 230.6 151 5.0 55
# of pts 115 115 115 115 114 114 111

Experience: Blood draw for laboratory tests in the neonatal population often leads to multiple transfusions secondary to iatrogenic blood loss. Frequent blood gases and chemistry values are often needed to optimize care in the critically ill child.

Conclusions: The VIA LVM system was found to be precise and accurate when utilizing both CLIA accepted standards and Bland and Altman statistical analysis. The potential advantages of monitoring with the VIA LVM include reduced need for blood transfusions, decreased infection risk to the patient, instantaneous resulting of values, the ability to monitor values frequently at a relatively fixed cost, and significant reduction in pre-analytical error.

OF-99-116

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