Annals of clinical biochemistry
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Ann. Clin. Biochem. · May 2017
Stability of ionized calcium measurements at concentrations less than 0.3 mmol/L by point-of-care blood gas instruments: application for postfilter calcium quality control in patients with citrate anticoagulation during extracorporeal circulation.
Background Measurements of ionized calcium (Ca2+) at concentrations less than 0.3 mmol/L are required for postfilter control in patients who receive extracorporeal circulation with sodium citrate anticoagulation. This study evaluates the stability of the Ca2+ measurements at such concentrations. Methods The stability of the Ca2+ measurements was tested by measuring daily the external standard Qualicheck concentration 3 s7950, Radiometer (0.22-0.25 mmol/L) by blood gas instruments ABL800 and ABL90, Radiometer. ⋯ Conclusions For ABL800 instruments, it is necessary to use an extra quality control (<0.3 mmol/L) in addition to the usual quality controls to monitor Ca2+ measurements below 0.3 mmol/L. The acceptable stability of the Ca2+ measurements can be achieved by the Ca2+ membrane and sensor cassette replacement after four weeks. If the usual 12 weeks of Ca2+ membrane lifetime is maintained, it may result in a clinically significant overestimation of Ca2+ by ABL800 instruments.