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dc.contributor.authorMorgan, Thomas J
dc.contributor.authorAnstey, Chris M
dc.contributor.authorWolf, Matthew B
dc.date.accessioned2021-07-01T01:15:56Z
dc.date.available2021-07-01T01:15:56Z
dc.date.issued2017
dc.identifier.issn1387-1307
dc.identifier.doi10.1007/s10877-016-9861-5
dc.identifier.urihttp://hdl.handle.net/10072/405547
dc.description.abstractWe aimed to evaluate the sensitivity and specificity of 8 biochemical scanning tools in signalling the presence of unmeasured anions. We used blood gas and biochemical data from 15 patients during and after cardio-pulmonary bypass. Sampling time-points were pre-bypass (T1), 2 min post equilibration with priming fluid containing acetate and gluconate anions (T2), late bypass (T3) and 4 h after surgery (T4). We calculated the anion gap (AG), albumin—corrected anion gap (AGc), whole blood base excess (BE) gap, plasma BE gap, standard BE gap and the strong ion gap (SIG), plus 2 new indices—the unmeasured ion index (UIX) and unmeasured plasma anions according to the interstitial, plasma and erythrocyte acid–base model (IPEua). Total measured plasma concentrations of acetate and gluconate [XA] were proxies for unmeasured plasma anions. [XA] values (mmol/L) were 1.41 (0.87) at T1, 11.73 (3.28) at T2, 4.80 (1.49) at T3 and 1.36 (0.73) at T4. Corresponding [albumin] values (g/L) were 32.3 (2.0), 19.8 (2.6), 21.3 (2.5) and 29.1 (2.3) respectively. Only the AG failed to increase significantly at T2 in response to a mean [XA] surge of >10 mEq/L. At an [XA] threshold of 6 mEq/L, areas under receiver –operator characteristic curves in rank order were IPEua and UIX (0.88 and 0.87 respectively), SIG (0.81), AGc (0.79), standard BE gap (0.77), plasma BE gap (0.71), BE gap (0.70) and AG (0.59). Similar ranking hierarchies applied to positive and negative predictive values. We conclude that during acute hemodilution UIX and IPEua are superior to the anion gap (with and without albumin correction) and 4 other indices as scanning tools for unmeasured anions.
dc.description.peerreviewedYes
dc.languageEnglish
dc.publisherSPRINGER HEIDELBERG
dc.relation.ispartofpagefrom449
dc.relation.ispartofpageto457
dc.relation.ispartofissue2
dc.relation.ispartofjournalJournal of Clinical Monitoring and Computing
dc.relation.ispartofvolume31
dc.subject.fieldofresearchBiomedical engineering
dc.subject.fieldofresearchClinical sciences
dc.subject.fieldofresearchcode4003
dc.subject.fieldofresearchcode3202
dc.subject.keywordsScience & Technology
dc.subject.keywordsLife Sciences & Biomedicine
dc.subject.keywordsAnesthesiology
dc.subject.keywordsCardio-pulmonary bypass
dc.subject.keywordsIPE model
dc.titleA head to head evaluation of 8 biochemical scanning tools for unmeasured ions
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationMorgan, TJ; Anstey, CM; Wolf, MB, A head to head evaluation of 8 biochemical scanning tools for unmeasured ions, Journal of Clinical Monitoring and Computing, 2017, 31 (2), pp. 449-457
dcterms.dateAccepted2016-03-08
dc.date.updated2021-07-01T01:13:54Z
gro.hasfulltextNo Full Text
gro.griffith.authorAnstey, Christopher


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