A-387 Evaluation of the Analytical and Clinical Performance of epoc Point of Care Equipment Compared to Standard Blood Gas in Patients with Nephropathy
Authors: Paula R F , Távora P F , Gomes M M , Neto J D , Leonel T C , Santos L I , Midrigal A D 
Published: September 2023

Abstract

Backgroud
Chronic kidney disease (CKD) is a public health problem, characterized by progressive loss of function of nephrons with consequent loss of ability to filter blood and maintain homeostasis. Due to the absence of symptoms, CKD usually receives a late diagnosis, which causes the patient to be immediately submitted to the hemodialysis procedure. Therefore, it is important that the patient has a fast and effective diagnosis, however it is necessary that it be done with clinical and analytical safety.

Objective
This study aimed to evaluate the performance of siemens Healthineers epoc® platform for the quantification of blood gas parameters, glucose, creatinine, ions, hemoglobin, hematocrit comparing this equipment with the reference methodology for blood gases in patients with CKD.

Methods
Eighty-five blood samples obtained from patients under clinical follow-up with nephrologists were collected and processed at epoc® and compared with the RapidPoint®500e Siemens Healthineers platform. Creatinine was compared with Abbott platform Architect®. Discrepancies related to clinical values and/or analyses were evaluated, considering the reference values determined for each method. For analytical verification, we analyzed the means of the results of each methodology, the percentage differences between the means of the results and Pearson's correlation coefficient.

Results
For clinical analysis considering the reference values for each method, all analyses were approved. Pearson's correlation coefficient was obtained for pH = 0.97, for pCO2 = 0.953 and pO2 = 0.9947. For glucose, the value of 0.9919 was obtained and for the ions, 0.887 for Na+ (sodium), 0.9727 K+ (potassium) and 0.9406 for Cl- (chloride). For Hb and Hct were 0.825 and 0.8231, respectively. For creatinine it was 0.9339. The analysis showed the differences in mean for Hb = 2.25%, Hct = 2.22%, ph = 0.1505%, pCO2 = 10%, pO2 = 6.28%, Na+ = 1.84%, Cl- = 3.93%, K+ = 1.77%, while glucose was 2.43% difference and creatinine 1.152%. The range analyzed for Hbt was 5.4–20.4, for ph of (7.133–7.475), for POC2 (29.8–115.8), for pO2 (15.1–118.4), for (Na+ 124.0–150.0), for (K+ 1.50–7.80), for (Cl- 92.0–121.0) and for K+ (1.50–7.80), for glucose (43.0–303.0). For creatinine it was (0.63–15.00) and (16.0–60.0) for hematocrit. In the accuracy evaluation, was obtained: Na+ (CVg = 2,4/DP = 3,29), K+ (CVg = 17,8/DP = 0,84), Cl-(CVg = 4,5/DP = 4,68), Glucose (CVg = 47,2/DP = 75,83), Creatinine (CVg = 32,6/DP = 3,10), ph (CVg = 0,883/DP = 0,065), pCO2 (CVg = 26,68/DP = 12,82), pO2 (CVg = 50,15/DP = 29,42), Hct (CVg = 24,43/DP = 9,0), Hbt (CVg = 24,43/DP = 3,08).

Conclusion
The study proved good results for the comparability between the epoc equipment® and the standard methodology. In addition, there was no difference in the clinical interpretation of patient studied, which is essential to ensure the safety in the use of these methodologies in the diagnosis and follow-up of CDK.